Endoscope with pannable camera and related method

ABSTRACT

An endoscope and related method comprise a proximal handle and a distal shaft having an insertion end. A housing comprising a camera assembly may be mounted on an insertion end of the shaft and include at least one lens and an image sensor. The camera assembly housing is rotatable about an axis perpendicular to the long axis of the shaft, giving the camera assembly a variable field of view. The rotatable camera assembly housing may be mounted to the insertion end of the shaft so that the rotatable housing of the camera assembly comprises the distal-most element of the endoscope shaft or insertion end. The endoscope may include a circuit board having a first portion disposed within the proximal handle and one or more extension portions that extend within the shaft to the camera assembly and/or to a light source near the distal end of the shaft. At least one light emitter may be mounted on the insertion end of the shaft and configured to project light in a direction either toward or away from the field of view of the camera assembly. The light emitter may also be mounted on the camera assembly housing to direct light toward the field of view of the camera assembly. Power and communication lines can be co-located within a lumen of the shaft of the endoscope used for fluid irrigation or suction.

CROSS-REFERENCES TO RELATED APPLICATIONS

This is a Non-Provisional application claiming the benefit of U.S.Provisional Patent Application Ser. No. 62/306,288, filed Mar. 10, 2016entitled Endoscope with Pannable Camera and Related Method, and U.S.Provisional Patent Application Ser. No. 62/212,871, filed Sep. 1, 2015entitled Endoscope with Pannable Camera and Related Method, which arehereby incorporated herein by reference in their entireties.

The present application is also a Continuation In Part application ofU.S. patent application Ser. No. 14/170,080, filed Jan. 31, 2014entitled Endoscope with Pannable Camera and International PatentApplication Serial No. PCT/US14/014243, filed Jan. 31, 2014, nowPublication No. WO2014/12116, published Aug. 7, 2014 entitled Endoscopewith Pannable Camera.

U.S. patent application Ser. No. 14/170,080, filed Jan. 31, 2014entitled Endoscope with Pannable Camera claims the benefit of U.S.Provisional Patent Application Ser. No. 61/826,303, filed May 22, 2013entitled Endoscope with Pannable Camera and U.S. Provisional PatentApplication Ser. No. 61/759,784, filed Feb. 1, 2013 entitled PannableEndosope each of which is hereby incorporated herein by reference in itsentirety.

BACKGROUND Field of Disclosure

The present disclosure relates to endoscopic instruments for viewing andworking in relatively inaccessible spaces; and in some aspects foroperating in tight anatomical spaces within a body using an endoscope orarthroscope, or the like.

Background Information

The use of endoscopic instruments in medicine, allowing for remoteviewing and operating in difficult-to-access spaces has becomewell-established. These instruments have also been useful in automotive,aviation, plumbing, electronics, and many other industries. In the fieldof medicine or veterinary practice, endoscopy or arthroscopy is oftenused to view or treat an anatomical region when minimal or no incisionsare desired, or to avoid disturbing nearby tissues. In orthopedics, forexample, the condition of a joint such as a knee or shoulder may beaccessed using one or more arthroscopic instruments introduced into thejoint through one or more small skin incisions. These instruments mayalso be used to repair various intra-articular tissues. Standardtechniques of open surgery to view and repair these anatomical areas canbe comparatively more time consuming, associated with greater risk andtrauma to a patient, and can be associated with longer recovery time.Furthermore, anesthesia associated with open surgery may be morecomplicated, risky and costly. For improved field of view, an endoscopemay be equipped with an actively flexible distal segment, controllableby the user at the handle end of the instrument. This may not be aneffective option when the tip of the instrument is positioned in aconfined space that may not accommodate the range of motion required forflexing the distal segment of an endoscope. In medical applications, onesuch example would include intra-articular surgery. Generally, using aninstrument with a rigid insertion shaft may be preferred if the use ofan instrument with an actively flexible distal segment is impractical. Anon-flexible shaft may provide improved optics or image reproduction,increased space within the instrument for additional functionality, andgreater durability. However, rigid endoscopes or arthroscopes have alimited field of view and may need to be repositioned or rotatedfrequently to increase the field of view. Some endoscopes orarthroscopes must be physically removed from the patient to have partsswapped out in order to change the field of view. Cannula systems mayfacilitate this approach, but may also increase the complexity of theprocedure and the size of an incision. These limitations may reduceoperator efficiency, increase surgery time, and may increase the risk ofiatrogenic injury. In medical and other applications, it would beadvantageous for an endoscope to have an increased or variable field ofview without the use of an actively flexible distal segment. It may alsobe advantageous to combine functions within a single conduit in order todecrease the overall diameter of the shaft of an endoscope.Additionally, current instruments are prone to degradation in functionand optical quality over repeated use, cleaning and/or sterilization. Anendoscope design whose manufacturing and assembly cost is low enough toeconomically justify its non-re-use would also be advantageous. Thecosts of repeated cleaning or sterilization and re-packaging would beeliminated, and it may also be easier to standardize the sterility,quality and reliability of a single-use device.

SUMMARY

An endoscope may comprise a proximal handle and a shaft having a distalinsertion end at which a camera assembly is mounted in a rotatablehousing. The rotatable housing is configured to rotate about an axisgenerally perpendicular to a long axis of the insertion end, with therotatable housing being the distal-most element of the endoscope at theinsertion end. The camera assembly may include a lens adjacent to animage sensor, which can be a CMOS or CCD device. A pull wire may extendfrom the handle to the insertion end of the shaft, the pull wirewrapping around a portion of the rotatable housing, and configured torotate the housing upon for and aft movement of the pull wire in theendoscope shaft. The housing may have a range of motion that providesthe camera assembly a field of view that includes a region in line withthe long axis of the insertion end and a region at least perpendicularto the long axis of the insertion end. In some cases this may comprise arange of about 0 degrees to about 120 degrees with respect to the longaxis of the insertion end, or between about 35 degrees and about 115degrees. The housing may be a spheroid shell constructed from twohalf-shells in which a cutout of one or both shells is configured toaccommodate an image sensor or camera assembly (e.g. lens plus imagesensor). The light source may be mounted on the rotatable housing sothat it can illuminate the field of view to which the camera assembly ispointing.

In another aspect, an endoscope may comprise a proximal handle and ashaft having a distal insertion end, the camera assembly configured torotate about an axis generally perpendicular to a long axis of theinsertion end. A light source may be located on the insertion end of theshaft, and oriented to project light in a direction generallyperpendicular to the long axis of the insertion end. The rotation rangeof the field of view of the camera assembly may include the areailluminated by the light source, or alternatively it may exclude thearea illuminated by the light source. In this case, the illumination bythe light source provided to the image sensor or camera is indirect,reflected or ambient light. The light source may comprise one or moreLED's.

In another aspect, an endoscope may include a printed circuit board(PCB) that comprises a base portion residing within a handle of theendoscope, and one or more elongate extension portions of the PCBconfigured to extend from the base portion of the PCB in the handlethrough a shaft of the endoscope, and terminating at a distal insertionend of the shaft. The base portion of the PCB may be a composite of aflexible board mated to or sandwiched with a rigid board, at least oneof the extension portions comprising a flexible board extension, or atleast one of the extension portions comprising a rigid board extension,or at least two of the extension portions comprising a flexible boardextension and a rigid board extension. A proximal leg of the flexibleboard extension may be angled at about 90 degrees to a proximal end ofthe rigid board extension, and a distal leg of the flexible boardextension may curve back to be parallel to the rigid board extension.The proximal leg of the flexible board extension can then be folded soas to bring the distal leg of the flexible board extension intoalignment adjacent to the rigid board extension. Both the rigid boardextension and the flexible board extension may extend through a lumen ofthe shaft of the endoscope. The PCB and its extensions may be coatedwith a water resistant coating or membrane, so that the extensions canrun through a fluid carrying lumen of the endoscope shaft. The flexibleboard extension can be connected to a rotatable image sensor (such as aCMOS or a CCD) in the distal insertion end of the endoscope shaft, whilethe rigid board extension can be connected to one or more stationarylight sources at the insertion end of the shaft. The flexible boardextension is configured to have sufficient slack to allow free rotationof the image sensor within a pre-determined rotational range.

In another aspect an endoscope may comprise a proximal handle housingconfigured to house an electronic processing board for processingsignals from an image sensor located at a distal end of a shaft of theendoscope. A distal handle housing is configured to hold the electronicprocessing board in a position fixed with respect to the distal handlesection. One or more magnets are attached to an internal wall of theproximal handle housing, said magnets being located next to a Halleffect sensor on the electronic processing board. Thus the proximalhandle housing is rotatable with respect to the distal handle housing,and the Hall effect sensor is configured to provide a signal to anelectronic processor representing the relative rotation of the proximalhandle housing with respect to the distal handle housing. The electronicprocessor may be connected to a user interface displaying an imagegenerated by the image sensor, and a rotational orientation of the imagecan thus altered by a change in the relative rotation of the proximalhandle housing with respect to the distal handle housing.

In another aspect, an endoscope comprises a handle enclosing anelectronic processing board for processing signals from an image sensorlocated at a distal end of a shaft of the endoscope. A button on thehandle includes a member that encloses a magnet positioned above oradjacent to a portion of the electronic processing board on which a Halleffect sensor is located. Thus depression, release or movement of thebutton alters a magnetic field near the Hall effect sensor sufficientlyto alter a signal produced by the Hall effect sensor. The button can beconfigured to cause an electronic controller connected to the electronicprocessing board to start a recording of an image generated by the imagesensor, to stop a recording of an image generated by the image sensor,or to take a photograph of an image generated by the image sensor, basedon a movement or release of the button by a user. The button can also beconfigured to cause an electronic controller connected to the electronicprocessing board to turn on, turn off, or adjust a light source locatedat a distal insertion end of a shaft of the endoscope, based on amovement or release of the button by a user. The movement or release ofthe button may comprise a short or longer duration depression of thebutton, a pre-determined series of two or more depressions and releasesof the button, or a release of the button between two depressions havingtwo or more variable durations.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other aspects will become more apparent from the followingdetailed description of the various embodiments of the presentdisclosure with reference to the drawings wherein:

FIG. 1 is a representational illustration of a two-component handledesign for an endoscope;

FIG. 2 shows additional features of the illustration of FIG. 1;

FIG. 3A shows an exemplary side view of an endoscope;

FIG. 3B shows an exemplary perspective view of another endoscope;

FIG. 4 shows a disassembled view of an example of a handle proximalsection of an endoscope;

FIG. 5 shows a disassembled view of an alternate example of a handleproximal section of an endoscope;

FIG. 6 shows a disassembled view of an alternate example of a handleproximal section of an endoscope;

FIG. 7A shows a top perspective view of an example of a handle distalsection of an endoscope;

FIG. 7B shows a side view of an example endoscope with a portion of thehandle removed;

FIG. 7C shows a detailed view of a portion of an example handle distalsection of an endoscope;

FIG. 8 shows an exploded view of a handle distal section and an exampleof a rotation sensing assembly of an endoscope;

FIG. 9A shows a partially assembled view of an exemplary endoscopehandle;

FIG. 9B shows a partial cutaway view of a handle of an endoscopeincluding an example rotation sensing arrangement;

FIG. 10A is a representational illustration of a pass-through fluidbarrier allowing utility components to pass from the handle to a conduitof an endoscope;

FIG. 10B shows a representational illustration of a pass-through barrierwith a flexible component;

FIG. 11A shows an exploded view of an example of an inner sheath mountserving as a pass-through fluid barrier;

FIG. 11B shows an example embodiment of a bulkhead or pass-through fluidbarrier;

FIG. 11C shows another example embodiment of a bulkhead or pass-throughfluid barrier;

FIG. 11D shows an embodiment of a pass-through barrier through which anumber of utility components extend;

FIG. 12 shows an exploded view of an example of a pivot controlassembly;

FIG. 13 shows a perspective view of an example of a sealing member;

FIG. 14 shows a partially assembled view of an exemplary endoscope withan inner sheath mount, a pivot control structure or assembly, andsealing member in their assembled locations;

FIG. 15 shows another partially assembled view of an example endoscopewith a pass-through barrier, pivot control structure, and printedcircuit board encased in a protective material or housing;

FIG. 16 shows a perspective view of an outer sheath mount;

FIG. 16A shows a perspective view of an outer sheath and mount of anendoscope;

FIG. 16B is a rear perspective view of the outer sheath and mount ofFIG. 16A;

FIG. 17 shows a close up partial view of an endoscope in which an innersheath mount, inner sheath, and outer sheath are in their assembledlocations;

FIG. 17A shows an exemplary trocar or obturator for insertion into anouter sheath of an endoscope;

FIG. 18 shows an example of a camera assembly mount separated from aninner sheath;

FIG. 19 shows an alternate example of a camera assembly mount as part ofan inner sheath;

FIG. 20 depicts a cross-sectional view of example camera assembly mountand inner sheath of FIG. 19 taken at line 20-20 of FIG. 19;

FIG. 21 shows an example of a camera assembly, part of an outer sheath,and part of a camera assembly mount;

FIG. 22 shows an alternate example of a camera assembly, part of anouter sheath, and part of a camera assembly mount;

FIG. 23 shows an alternate example of a camera assembly, part of anouter sheath, and part of a camera assembly mount;

FIG. 23.1 shows a perspective view of the distal end of an endoscopeshaft in which the camera assembly is mounted at the tip of the shaftwithout a protective guard, shield or tip structure;

FIG. 23.2 shows a rotatable camera housing with pull wire, and a bank ofLED's at an exposed end of an endoscope shaft (surrounding sheathremoved);

FIGS. 23.3 and 23.4 show each half of a spheroid rotatable housing for acamera assembly;

FIGS. 23.5 and 23.6 show the pivoting and bearing elements allowing forrotation of a housing for a camera assembly;

FIG. 24 shows a perspective view of a camera assembly;

FIG. 25 shows a side view of a camera assembly and a camera assemblymount with a wall of the camera assembly mount removed for clarity;

FIG. 26 shows a side view of an alternate exemplary camera assembly andcamera assembly mount with a wall of the camera assembly mount removedfor clarity;

FIG. 27 shows a side view of an alternate exemplary camera assembly andcamera assembly mount with a wall of the camera assembly mount removedfor clarity;

FIGS. 28-32 depict some of the possible rotational positions of analternate camera assembly;

FIG. 33 shows an example camera assembly;

FIG. 33.1 shows a relationship between a camera assembly and LED's andtheir respective power and communications PCB extensions;

FIG. 33.2 shows a form factor for a PCB for an endoscope with extensioncomponents for the endoscope shaft;

FIG. 33.3 shows the PCB of FIG. 33.2 with one flexible extension foldedover another extension of the PCB;

FIG. 33.4 shows how the PCB extensions are positioned in an endoscopeshaft (sheath removed);

FIG. 33.5 shows a partially assembled endoscope showing a pass-throughfluid barrier or bulkhead and PCB;

FIG. 33.6 shows a relationship between an endoscope PCB and otherinternal components of the endoscope handle;

FIG. 33.7 shows a fluid carrying lumen and PCB extensions located withinan inner sheath of an endoscope shaft;

FIG. 33.8 shows an internal fluid path within the handle of anendoscope;

FIG. 34 shows an example camera assembly with attached optical fiberbundle and electronic flex cable;

FIG. 35 shows a top view of an exemplary camera assembly and cameraassembly mount;

FIG. 36 shows a perspective view of a camera assembly and flexibleoptical fiber bundle or ribbon;

FIG. 37 shows a perspective view of a camera assembly having amonolithic camera housing and light emitting feature;

FIG. 38 shows a side view of the camera assembly of FIG. 37;

FIG. 39 shows an example of a flexible optical fiber bundle or ribbon;

FIG. 40 shows a side view of the flexible optical fiber ribbon of FIG.39;

FIG. 41 shows a perspective view of an example of a light projectionelement;

FIG. 42 shows a perspective view of another example of a lightprojection element;

FIG. 43 shows a perspective view of another example of a lightprojection element;

FIG. 44 shows a bottom perspective view of the light projection elementshown in FIG. 43;

FIG. 45 shows a cross sectional view of the light projection elementshown in FIGS. 43 & 44 taken at line 43-43 of FIG. 43;

FIG. 46 shows a cross sectional view of the light projection elementshown in FIGS. 43 & 44 taken at line 44-44 of FIG. 43;

FIG. 47 shows a cross sectional view of the light projection elementshown in FIGS. 43 & 44 taken at line 45-45 of FIG. 43;

FIG. 48 shows a top perspective view of a camera assembly on which thelight projection element of FIG. 43 is mounted;

FIG. 63 shows a cross sectional view of an example camera assembly takenat line 61-61 of FIG. 24;

FIG. 64 shows a cross sectional view of an example camera assembly takenat line 62-62 of FIG. 34;

FIG. 65 shows a cross-section view of an example camera assembly takenat line 62-62 of FIG. 34;

FIG. 66 depicts a representational illustration of a camera assembly atthe distal tip of an endoscope in addition to an example sensor andnumber of example illumination sources;

FIG. 67 depicts a top down view of an example printed circuit boardwhich includes an extension portion for projection into an endoscopeshaft;

FIG. 68 depicts a side view of an example printed circuit boardincluding a projecting portion;

FIG. 69 depicts an example flowchart detailing a number of example stepswhich may be used to control, with a processor, at least one variablelight source of an endoscope based on received sensor data;

FIG. 70 shows a side view of a projecting portion of a printed circuitboard having an example camera assembly, example sensor, and number ofexample light sources mounted thereto;

FIG. 71 shows a top down view of a distal tip of an example endoscopeincluding the example projecting portion of a printed circuit boardshown in FIG. 70;

FIG. 72 shows a cross sectional view of the distal tip of an endoscopetaken at line 72-72 of FIG. 71;

FIG. 72.1 shows a perspective view of the distal end of an endoscopeshaft in which the light source is located on the shaft to project lightin a direction generally away from the field of view of the cameraassembly;

FIG. 73 depicts an example endoscope and example calibration fixture;

FIG. 74 depict flowchart including a number of example steps which maybe used to calibrate lighting parameters values for variableillumination sources of an endoscope;

FIG. 96 shows a partially assembled view of an endoscope with a handleprinted circuit board, power/HDMI cable, illumination fibers, andirrigation line in their assembled locations;

FIG. 97 shows a block diagram of an example image processing system; and

FIG. 98 depicts an example diagram illustrating how an image may berighted using input from a rotation sensing assembly.

DETAILED DESCRIPTION

The terms ‘endoscope’ and ‘arthroscope’ as used herein are meant to beused interchangeably and are to be given their broadest interpretation,each term denoting an instrument having an elongate section forinsertion into a space that is otherwise difficult to access, for thepurpose of visual inspection, diagnosis and/or treatment or repair. Inthe field of medicine or veterinary practice, such a space may include abody or organ cavity, joint space, tissue plane or other body structure.The instrument may also be used in a number of non-medical (e.g.,industrial) applications, in which the diameter of the insertion portionof an endoscope needs to be minimized, or in which the space withinwhich an endoscope must operate is too confined to permit the use of anactively flexible distal segment.

A two-component handle design of an endoscope 10 is shown in FIG. 1. Theexample endoscope 10 includes a handle proximal section 16 and a handledistal section 30. The handle proximal section 16 may be a housing. Asshown, the handle distal section 30 may extend at least partially intothe handle proximal section 16. The handle distal section 30 and thehandle proximal section 16 may be rotatable relative to each other. Insome embodiments, a user may hold the handle proximal section 16immobile while rotating the handle distal section 30 with a thumb orfinger. The endoscope 10 may have a number of features such as, but notlimited to, a rotation sensing assembly, fluid conduits, lighting, animager or camera assembly, pivot control for the imager etc.

Additional features of the endoscope 10 are represented in FIG. 2. Theendoscope 10 includes a handle proximal section 16 and a handle distalsection 30. In this example, at least a part of an insertion shaft orsection 14 is fixed to the handle distal section 30 and moves with thehandle distal section 30. The handle distal section 30 includes a handleprotuberance or fin 36 which provides a surface for a user to pressagainst to facilitate rotating the handle distal section 30 relative tothe handle proximal section 16. In some embodiments, a user's hand mayhold the handle proximal section 16 immobile while the handle distalsection 30 is rotated using one of the user's fingers or thumb.

In some embodiments, one or both the handle proximal section 16 and thehandle distal section 30 may function as a housing or provide a supportstructure for other components of the endoscope 10. The endoscope 10shown in FIG. 2 may include a rotation sensing assembly 150. Therotation sensing assembly 150 may track the rotation of handle distalsection 30 relative to the handle proximal section 16. In someembodiments, the rotation sensing assembly 150 may include a componentwhich is stationary with respect to the handle proximal section 16 and acomponent that is stationary with respect to the handle distal section30. For example, the rotation sensing assembly 150 may include apotentiometer and a keyed shaft. The potentiometer may be mounted, forexample to a support member comprising the internal housing of thehandle proximal section 16. Alternatively, the handle distal section 30may also comprise a support member for mounting one or more componentsof the rotation sensing assembly 150 (see for example the rotationsensor holder in FIG. 8). In either case, a rotational or translationalcomponent of the rotation sensing assembly is arranged to move inproportion to the degree of rotation of the handle distal section 30relative to the handle proximal section 16.

An exemplary embodiment of an endoscope (or, e.g., arthroscope) 10 isshown in FIG. 3A. The endoscope 10 may be used in various endoscopicprocedures, including arthroscopy, among others. As shown, the endoscope10 includes a handle 12 and an insertion section or shaft 14, which maycomprise an elongate hollow shaft within which one or more actuationmembers, electrical/communications wires, lighting or light-transmittingcables and/or fluid channels may be located. As shown, in an embodimentthe handle 12 may be roughly cylindrical and rounded in shape. Theinsertion section 14 may also be roughly cylindrical in shape and extendalong a longitudinal axis. In an embodiment, the insertion section 14may be rigid and relatively straight. In other embodiments, theinsertion section 14 may be curved or angled along at least a portion ofits length. In yet other embodiments, the insertion section 14 maycomprise semi-rigid, malleable material permitting it to be bent andheld to a desired shape. The diameter of the insertion section 14 issignificantly smaller than that of the handle 12. In some embodiments,the diameter of the insertion section 14 may be approximately 5.5 mm orsmaller. The insertion section 14 of the endoscope 10 may be roughly thesame length as that of the handle 12. In alternative embodiments, thelengths and shapes of the handle 12 and insertion section 14 may differsubstantially.

At least a portion of the insertion section 14 may be detachable fromthe handle 12. In such embodiments, the insertion section 14 ordetachable portion of the insertion section 14 may be coupled to thehandle 12 by any of a variety of means including, but not limited tofriction fit, snap fit, threaded coupling, bayonet mount, etc. In someembodiments, the insertion section 14 may be a disposable component andthe handle 12 may be a reusable component. In embodiments in which theinsertion section 14 is disposable, the insertion section 14 may bediscarded after use. In other embodiments, the insertion section 14 maybe sterilized after use via an autoclave, solution soaking, or othersuitable sterilization procedure. In a preferred embodiment, both thehandle 12 and the insertion section 14 are disposable and may bediscarded after use, obviating the need for and cost of sterilizationprocedures and equipment (aside from a pre-usage sterilization withethylene oxide, radiation, or the like, during, for example,manufacture, assembly or packaging of the device). Additionally, bymaking both the handle 12 and insertion section 14 of the endoscope 10disposable, there is no degradation in function or reliability resultingfrom repeated use and repeated cleaning. Making the entire endoscope 10disposable has other benefits, some which will be discussed below.

Preferably, a disposable endoscope 10 may be equipped with a means toprevent its reuse, particularly if sterilization of a used instrument islikely to degrade its function. For example, the endoscope 10 mayinclude a memory chip storing an identification code that can berecognized by an electronic processor in a base unit to which theendoscope 10 must be connected for operability and display of images.The connection may include wired communications between a controller inthe base unit and a memory chip in the endoscope 10, or, for examplewireless communications using an RFID device mounted in the endoscope10. (Other types of wireless transmission, such as, e.g. Bluetooth orWi-Fi, may also be used). In an embodiment, the base unit may beprogrammed to encode a memory device on the endoscope 10 upon first use,and may be programmed to read and identify a code signifying that theendoscope 10 has been previously used whenever the endoscope 10 issubsequently re-connected to any base unit. Upon identification of a‘used’ endoscope 10, the controller may be programmed to preventelectronic and imaging communications between the endoscope 10 and thebase unit. The code and its communication may be encrypted to enhancesystem security. Alternatively, the endoscope 10 may include adisablement feature in its software which renders the endoscope 10inoperable after usage.

As shown in FIG. 3A, the handle 12 of the endoscope 10 may include anumber of different features. The handle 12 may include a handleproximal section 16. The handle proximal section 16 may be relativelysmooth as shown in FIG. 3A. The handle proximal section 16 may compriseone or more hollow sections. The handle proximal section 16 may also becontoured such that it includes a number of ergonomic attributes. Insome embodiments, at least a portion of the handle proximal section 16may not have a smooth surface and may include a knurled, ribbed,roughened, honeycombed, etc. type texture, and/or a rubberized orelastomeric surface layer to facilitate gripping the endoscope 10 duringits operation. In the example embodiment, the handle proximal section 16is formed with a number of finger grooves 18. In some embodiments, thehandle proximal section 16 may be made of a material (e.g. rubber orother elastomer) that has a soft feel or is otherwise comfortable tohold. In some embodiments, a pistol grip-like feature (not shown) may beincluded as part of the handle proximal section 16.

As shown in FIG. 3A, the handle proximal section 16 may be divided intotwo separate parts. The handle proximal section 16 in FIG. 3A includes ahandle top section 20 and a handle bottom section 22. The handle topsection 20 and handle bottom section 22 of the handle proximal section16 may be manufactured as two separate parts and coupled together by anysuitable means, such as, e.g., adhesive, screws, snap-fit, etc. Asshown, the handle top section 20 is smooth and contoured differentlyfrom the handle bottom section 22. This may help a user quickly andeasily determine orientation of the endoscope 10 by feel. In someembodiments the handle top section 20 and handle bottom section 22 maycomprise surface materials that have a different feel (e.g., metallicvs. plastic, metallic vs. elastomeric, smooth vs. textured, etc.).

The handle 12 of the endoscope 10 may also include a handle distalsection 30. As shown in FIG. 3A, the handle distal section 30 extendsfrom the handle proximal section 16 toward the insertion section 14. Thehandle distal section 30 may be smaller in diameter than the handleproximal section 16. As shown, the handle distal section 30 may belonger in length than the handle proximal section 16, but in alternateembodiments, the relative dimensions of the handle distal section 30 andhandle proximal section 16 may differ.

On at least a portion of the handle distal section 30 there may be agripping texture as shown in FIG. 3A. In the example embodiment shown inFIG. 3A, the grip texture is a series of spiraling ribs 32. In otherembodiments, other gripping textures, such as non-spiraling ribs, nubs,bumps, grooves, honeycomb patterning or other form of knurling orcheckering, etc. may also be used. As shown, the spiraling ribs 32 inthe example embodiment encircle most of the outer diameter of the handledistal section 30. In some embodiments including a gripping texture onthe handle distal section 30, the gripping texture may not be formed asa continuous part of the handle distal section 30. In such embodiments,the gripping texture may be a ‘skin’ or sleeve applied onto the handledistal section 30. The gripping texture skin may be coupled to thehandle distal section 30 by any suitable means such as, but not limitedto, adhesive, snap fit, various fasteners, over-mold, etc. In someembodiments, the gripping texture skin may be made of a materialdifferent from the handle distal section 30. The gripping texture skin,for example, may be a softer, elastomeric or rubbery, material which ismore comfortable to grip/less slippery than the handle distal section 30material.

In the example embodiment of FIG. 3A, the handle distal section 30includes a handle raised portion 34 projecting from the top of thehandle distal section 30. In this example, the handle raised portion 34does not project sharply up from the rest of the handle distal section30. Instead, the handle raised portion 34 may be constructed to gentlycurve up from the rest of the handle distal section 30. In this example,the spiraling ribs 32 do not extend over and onto the top of the handleraised portion 34. Additional features of the handle raised portion 34will be further described below.

In one aspect, projecting from the bottom of the handle distal section30 may be a handle fin or paddle 36. In this example, the handle fin 36may be constructed to gently curve away from the rest of the handledistal section 30 toward an inferior or dependent position of theendoscope 10. The spiraling ribs 32 may or may not extend over and ontothe bottom of the handle fin 36. In other embodiments, a handle fin 36may be configured to project from the top of the handle distal section30, while the handle raised portion 34 may be configured to project fromanother aspect of the handle distal section 30. The handle fin 36 may bedisposed so as to correspond to the location of an entry point forvarious cables, irrigation, etc. in endoscopes which may already befamiliar to a physician. This may be desirable since such an entry pointis often used as a surface to press against to facilitate rotation andas an orientation marker. Additional features of the handle fin 36 willbe further described below.

An alternative embodiment of an endoscope (or, e.g., arthroscope) 10 isshown in FIG. 3B. As shown, the endoscope 10 includes a handle 12 and aninsertion section or shaft 14, which may comprise an elongate hollowshaft within which one or more actuation members,electrical/communications wires, lighting or light-transmitting cablesand/or fluid channels may be located. At least a portion of the shaft 14may be detachable from the handle 12. In the example embodiment, theshaft 14 of the endoscope comprises an outer sheath or cannula 318attached to a mounting structure 15 which may facilitate attachment ofthe cannula to and detachment of the cannula from the handle 12 by anyof a variety of means including, but not limited to friction fit, snapfit, threaded coupling, bayonet mount, etc.

As shown in FIG. 3B, the handle 12 of the endoscope 10 may include ahandle proximal section 16 which encloses (among other components) aprinted circuit board (PCB) for controlling or processing image datadetected by a sensor at the distal end of the shaft, and/or forproviding power to light sources (e.g. LED's) at the end of the shaft.It may also house a fluid conduit for connecting to a fluid carryinglumen within the shaft 14. A handle proximal section 16 may be dividedinto two separate parts. The handle proximal section 16 in FIG. 3Bincludes a handle first half-shell 21 and a handle second half-shell 23.The handle first half-shell 21 and handle second half-shell 23 of thehandle proximal section 16 may be manufactured as two separate parts andcoupled together during assembly by any suitable means, such as, e.g.,adhesive, screws, snap-fit, etc and may be symmetrical. For example, thehandle first half-shell 21 may be ultrasonically welded to the handlesecond half-shell 23 using any ultrasonic welding techniques.Additionally, alternatively, or optionally, the hand half-shells 21, 23may be manufactured using injection molding techniques know in the art.

The handle 12 of the endoscope 10 may also include a handle distalsection 30. As shown in FIG. 3B, the handle distal section 30 extendsfrom the handle proximal section 16 toward the shaft 14. Projecting fromthe bottom of the handle distal section 30 may be a handle fin or paddle36. The handle distal section 30 also includes a recess 35 which issized to accommodate a finger contact 98 of a pivot control structure100 (see, e.g. FIG. 14). Examples of pivot control structures 100 arealso described below, and are used to rotate a pivotable sensor housingat the distal end of the shaft 14.

Also shown in FIG. 3B is a display or camera control button 37. It maybe used to capture images produced by the image sensor at the distal endof the shaft 14. In some embodiments, a user can depress the button 37using a pre-determined pattern or sequence to, for example, turn on oroff a video recording of images shown on a display of the field of viewof the image sensor at the distal end of the shaft 14, record a snapshotof the image shown on a display of the field of view of the image sensorat the distal end of the shaft 14, alter the brightness of the lightelements (e.g. LED's) at the end of the endoscope shaft 14, or adjustother characteristics of the sensor or displayed image (such as, e.g.,white balance, color saturation, digital magnification, etc.). It may bepreferable to have the sensor characteristics and LED illuminationcontrolled by a processor associated with a graphical user interfaceconnected to the endoscope, rather than by the endoscope PCB itself inorder to reduce the amount and cost of on-board processing power of theendoscope PCB.

The button 37 may operate an electromechanical switch located on themain PCB within the endoscope handle distal section 30. To ensuremaximum moisture resistance of the PCB electronic components, it may bepreferable to employ a magnetic or optical sensor assembly to detect themovements of button 37. As shown in FIG. 33.5 (showing relativepositions of some of the components within handle 12), in one embodimenta Hall effect sensor on the endoscope PCB 518 may be positioned belowand near the location of a shaft 38 connected to button 37. The button37 may be spring loaded, and the end of the shaft 38 closest to the PCB518 can be made to include an embedded magnet. As the button shaft 38 ismoved closer to or away from the PCB-based Hall effect sensor, thesensor can generate the appropriate signal corresponding to the positionof the button shaft 38 and its duration in that position.

FIG. 4 and FIG. 5 show example embodiments of a handle top section 20and handle bottom section 22 of the handle proximal section 16 shown inFIG. 3A. The handle top section 20 and handle bottom section 22 areshown in an uncoupled or disassembled view. The handle proximal section16 forms a shell-like structure when assembled. The handle bottomsection 22 may include a ledge 40 that wraps around a bottom sectioninner wall 42 at a distance from the top face 46 of the handle bottomsection 22. As shown, there is a curved or U-shaped cutout 44 in thehandle bottom section 22 disposed at an angle substantiallyperpendicular to the top face 46 of the handle bottom section 22. Twopeg projections 47 may be included near the rear of the handle bottomsection 22. The peg projections 47 may extend slightly above the ledge40 and be angled approximately perpendicular to the top face of theledge 40.

As shown in FIGS. 4 and 5, a portion of the handle top section 20 may bedimensioned so that it may be overlapped by the handle bottom section 22when the handle proximal section 16 is assembled. The overlapped section48 may be stepped in from the handle top section outer surface 50 asshown in FIGS. 4 and 5. The height of the overlapped section 48 may beselected so that it is approximately equal to or slightly greater thanthe distance between the top of the ledge 40 of the handle bottomsection 22 and the top face 46 of the handle bottom section 22. In suchembodiments, when fully assembled, the bottom face 52 (refers toorientation when assembled) of the handle top section 20 abuts the topof the ledge 40 of the handle bottom section 22. Additionally in suchembodiments, the handle top section outer surface 50 and handle bottomsection outer surface 54 may be flush with each other and form a nearlycontinuous surface with little gap between the two. In some embodiments,there may be a small gap between the handle top section outer surface 50and handle bottom section outer surface 54 (small gap shown in FIG. 3).

As shown, the handle top section 20 may include peg cutouts 59 which areshaped and disposed such that they may accept the peg projections 47 inthe handle bottom section 22. The handle top section 20 may include acurved cutout 58 at the butt or proximal portion of the handle topsection 20. As shown the curved cutout 58 may be recessed into thehandle top section 20 at an angle substantially perpendicular to thebottom face 52 (refers to orientation when assembled) of the handle topsection 20. When the handle proximal section 16 is assembled, the curvedor U-shaped cutout 44 of the handle bottom section 22 and the curvedcutout 58 of the handle top section 20 together may form a substantiallycircular or ovoid handle void or opening 60 which will be furtherdescribed below. It should be appreciated that the use of the terms“cutout”, “cut”, etc. herein should not be construed to imply materialmust be physically removed by a cutting or material removal process. Insome embodiments, the curved or U-shaped cutout 44 and the curved cutout58 may be formed during manufacture without physically removingmaterial.

As shown in FIG. 4 the handle bottom section 22 may include a shaftsupport member 63. The shaft support member 63 in FIG. 4 has a curved orsemi-circular portion which roughly corresponds to the location of thetoothed projection 62 in FIG. 5. The shaft support member 63 alsoincludes a post. The post projects perpendicularly from a mid-point ofthe semi-circular portion, leaving approximately 90° of thesemi-circular portion on each side of the post. Projectingperpendicularly from the top of the post of the shaft support member 63toward the distal end of handle proximal section 16 is a shaftsupporting section 65. The shaft supporting section 65 may include adepression in which a portion of a sensor gear shaft 120 (see FIG. 8)may be seated. The post of the shaft support member 63 may beapproximately the length of the radius of the semi-circular portion whenthe handle proximal section 16 is fully assembled. The shaft supportmember 63, toothed projection 62, and toothed projection 64 will befurther described below.

As shown in FIG. 5, the handle bottom section 22 may instead oroptionally include a curved toothed projection 62. The curved toothedprojection 62 is complemented by a similar toothed projection 64included on the handle top section 20. The toothed projection 62 andtoothed projection 64 may be disposed so that they are in line with oneanother and form an annulus or internal ring gear when the handleproximal section 16 is fully assembled.

As shown in FIGS. 4 and 5, the face of the handle bottom section 22opposite the curved or U-shaped cutout 44 and face of the handle distalsection 20 opposite the curved cutout 58 may include semi-circularopenings or voids 70. A curved or U-shaped track 72 may be recessed intothe edges of the semi-circular voids 70 along the entire arc of eachsemi-circular void 70 as shown in FIGS. 4 and 5.

FIG. 6 shows an example embodiment of a handle first half-shell 21 andhandle second half-shell 23 of the handle proximal section 16 shown inFIG. 3B. The handle first half-shell 21 and handle second half-shell 23are shown in an uncoupled or disassembled view. The handle proximalsection 16 forms a shell-like structure when assembled. One of the firstor second handle half-shells 21, 23 may include a slot 41 which is sizedto fit a cooperating wall extension 43 in the other of the first andsecond handle half-shells 21, 23 to facilitate assembly. Similar toFIGS. 4 and 5, the example embodiment in FIG. 6 includes curved cutouts58. These cutouts 58 allow access into the interior volume of theproximal handle section 16 when the proximal handle section 16 isassembled.

It may be useful to be able to track the rotational orientation of thehandle proximal section 16 in relation to the handle distal section 30,shaft 14, and the sensor or camera at the distal end of the shaft. In anembodiment, this can be accomplished through the interaction between aHall effect sensor and an associated magnet. The Hall sensor may bepositioned on the handle proximal section 16, with a magnet located onan internal component within the handle proximal section 16, or one ormore magnets may be positioned in the handle proximal section 16 withone or more associated Hall effect sensors mounted on a PCB within thehandle proximal section 16. In some embodiments, one or more magnets 51may be embedded in or attached to a part of the handle 12. In theexample embodiment shown in FIG. 6 the proximal handle section 16includes two magnets 51 situated generally opposite each other. Adifferent number of magnets 51 may be used in other embodiments. Asshown, in this case, each of the first and second handle half-shells 21,23 includes a magnet 51 inserted in an interior wall of eachhalf-section. In the example embodiment, the magnets 51 are coupled to aretaining structure 53 which holds the magnet 51 in place in theproximal handle section 16. The magnets optionally may be constructed ofany appropriate rare earth or transition metal, or alloy thereof.

The example handle distal section 30 of FIG. 3A is shown in FIG. 7Aisolated from the rest of the handle 12. FIG. 7A shows the handle distalsection 30 from a substantially top perspective view. As shown, thespiraling ribs 32 and front handle raised section 34 detailed above arevisible on handle distal section 30. As indicated by the seam runningdown the vertical center plane of the handle distal section 30, thehandle distal section 30 may be constructed as two or more separateparts (30 a and 30 b in the example embodiment) which are coupledtogether by any suitable means or combination of suitable means, suchas, e.g., snap fit, adhesive and/or screws.

The handle distal section 30 in FIG. 7A additionally includes a sectionnot shown in FIG. 3A. When the endoscope 10 is assembled, as it is inFIG. 3A, part of the handle distal section 30 may be housed inside thehandle proximal section 16. For example, a housed handle electronicssection 80 projects proximally from the external handle distal section82 (which is visible in both FIG. 3A and FIG. 7A). The housed handleelectronics section 80 will be further described below.

Between the housed handle electronics section 80 and the external handledistal section 82 is a small diameter span 84. As shown, the smalldiameter span 84 may include a rounded groove 86 which is recessed intothe outer surface of the small diameter span 84. In some embodiments,when fully assembled, the small diameter span 84 of the handle distalsection 30 may be disposed within the semi-circular openings 70 of thehandle proximal section 16. The rounded groove 86 in the small diameterspan 84 and the curved or U-shaped track 72 in the semi-circularopenings 70 may be in line with one another. This may allow the handledistal section 30 and handle proximal section 16 to be rotated relativeto one another as the endoscope 10 is used. Optionally, ball bearings(not shown) or other types of bearings may track along the roundedgroove 86 in the small diameter span 84 of the handle distal section 30and the U-shaped track 72 in the semi-circular openings 70 of the handleproximal section 16. In a preferred embodiment, an o-ring (not shown)may be placed in the rounded groove 86 of the small diameter span 84 ofthe handle distal section 30. The o-ring (not shown) may function as adynamic seal between the handle proximal section 16 and handle distalsection 30. In such embodiments, the handle proximal section 16 andhandle distal section 30 may be rotated relative to one another whilesealing the interior of the handle proximal section 16 from liquid.

A handle fin or paddle 36 or other protuberance may serve as anorientation marker for the user as the handle proximal portion 16 andhandle distal section 30 are rotated relative to one another.Orientation may be checked either visually or by feel. In someembodiments, the gripping texture on the handle fin/paddle 36 may bedifferent than spiraling ribs 32 on the rest of the handle distalsection 30 to facilitate orientation-checking by feel.

As shown in FIG. 7A, the handle raised section 34 may include a button90. In some embodiments, the handle raised section 34 may include morethan one button 90, or no button at all. The button 90 may be locatedelsewhere on the handle distal section 30 or elsewhere on the handle 12.In some embodiments, the handle raised section 34 may include a button90 and one or more additional buttons 90 may be located elsewhere on thehandle 12. In some embodiments, a button 90 may be a mechanicallyactuated switch including a depressible member which when depressedcompletes or breaks a circuit. The button 90 may comprise a magnetic orHall effect based switche by embedding a magnet into a portion of thebutton near a Hall effect sensor within the handle distal section 30.Other types of buttons or switches may be used. The button 90 may beassigned multiple functions that may be activated by various usermanipulations. In some embodiments one or more of the buttons 90 may besealed with respect to the external handle section 82 to inhibit liquidinfiltration.

The button 90 may be an image capture button. In such embodiments,depressing the button 90 may cause a photograph to be recorded of adisplay imaged generated by the endoscope 10. In some embodiments, auser may double tap the button 90, long-press the button 90, or holddown the button 90 to cause the display equipment connected to theendoscope 10 to start recording video. To stop recording video, a usermay double tap the button 90, long-press the button 90, or release thebutton 90. In some embodiments, a user may only be required to depressand release the button 90 to stop recording video. In some embodiments,a single depression of the button 90 by a user while the endoscope 10 isrecording video may cause a still image to be recorded without the needto pause video recording. In other arrangements, a quickpress-and-release of the button 90 may trigger the recording of a stillimage, while a more prolonged press-and-release, or a press-and-hold maytrigger the recording of a video segment.

The handle raised section 34 may additionally include a slide buttonrecess 92. As shown in FIG. 7A, the slide button recess 92 is arrangedto permit fore and aft movement of a slide button or finger contact 98(see FIG. 14) while constraining lateral movement. The slide button maybe part of a pivot control or pivot control structure 100 (see, forexample, FIG. 14) in some embodiments. In some embodiments, includingthe example embodiment shown in FIG. 7A, the slide button recess 92 maybe slightly curved to conform to the shape of the portion of the handlewithin which it resides.

As shown in FIG. 7A, the slide button recess 92 may include a number ofridges or detents 94 that can engage with a corresponding element on theslide button to provide a series of discrete, positive stops when a usermoves the slide button fore and aft. Some embodiments may not includethe ridges 94. In some embodiments, the portion of a pivot controlstructure 100 (see FIG. 12) with which a user may interface may projectthrough a pivot control structure notch 96 (see FIG. 14) located in theslide button recess 92 of the handle raised section 34. In the exampleembodiment in FIG. 7A, such a portion of the pivot control structure 100includes a finger contact 98. As shown, the finger contact 98 may havesloped contours for ergonomic reasons. The pivot control structure 100will be further described below.

FIG. 7B and FIG. 7C depict an alternate embodiment of a recess 35 whichmay be used to accommodate a finger contact 98 of a pivot controlstructure 100. A portion of the handle proximal section 16 and handledistal section 30 has been removed for clarity. FIG. 7C depicts a detailview of region 7C of FIG. 7B. As best shown in FIG. 7C, in someembodiments, the recess 35 includes ridges 94 for stepwise movement ofthe pivot control structure similar to those of the slide button recess96 shown in FIG. 7A. Alternatively, the recess 35 may be generallysmooth and may be curved to accommodate the travel path of a pivotcontrol structure 100.

The interior of the distal handle section 30 may include a shelf 95which is located beneath the recess 35. The shelf 95 may have a surfacewhose contour mimics the contour of the recess 35. The shelf 95 mayinclude one or more ridge(s) or detent(s) 94 to provide a series ofdiscrete, positive stops when a user moves the pivot control structure100 fore and aft. These ridges 94 may interact with one or more arms 97extending from the pivot control structure 100. The arms 97 may movefreely over portions of the shelf 95 which are smooth and devoid ofridges or ribs 94. When one of the arms 97 encounters a ridge 94, theridge may abut the respective arm of the arms 97 and impede furtherdisplacement of the pivot control structure 100 until a force sufficientto overcome the mechanical interference presented by the ridge 94 isapplied. That is, the ridges 94 may form force barriers that impede theactuation of the finger contact 98 out of a dwell position. Depending onthe embodiment, the ridges 94 may be placed in pairs along a face of theshelf 95. The each rib or ridge 94 of the pair of ridges 94 may beplaced apart by about the width of the arm 97 of the pivot controlstructure 100.

FIG. 8 shows a more detailed illustration of an exemplary handle distalsection 30 without an attached insertion section 14. An example rotationsensing assembly 150 is also shown in FIG. 8. As shown, the handledistal section 30 is manufactured as two separate parts 30 a and 30 b.In the example embodiment, the two separate parts 30 a and 30 b of thehandle distal section 30 include a number of screw holes 102, which maybe threaded. Screws (not shown) or other suitable fasteners may be usedto couple the two separate parts 30 a and 30 b of the handle distalsection 30 together. In some embodiments, the two separate parts 30 aand 30 b may be coupled together via a snap fit, ultrasonic weld,adhesive, etc.

In some embodiments one of the two separate parts 30 a and 30 b of thehandle distal section 30 may include peg-like projections 104 which fitinto complimentary peg accepting cavities 106 on the other of the twoseparate parts 30 a and 30 b. This may help to align and/or couple thetwo separate parts 30 a and 30 b together. In some embodiments,including the embodiment shown in FIG. 8, the external handle distalsection 82 may be substantially hollow. In some embodiments, the hollowof the external handle distal section 82 may not be sealed againstfluid. In the example embodiment shown in FIG. 8, a drain channel 108may be included, for example, in the handle fin 36. The drain channel108 may allow any fluid which enters the hollow of the external handledistal section 82 to easily drain out. Alternate embodiments may includeadditional and/or different drain arrangements.

The handle distal section 30 may also include a rotation sensor holder110 as shown in FIG. 8. The rotation sensor holder 110 may retain therotation sensing assembly 150 when the endoscope 10 is fully assembled.As shown, the rotation sensing assembly 150 may include a forward gear112. The forward gear 112 is disposed about a forward gear shaft 114. Asshown in FIG. 8, a transfer gear 116 is also placed on the forward gearshaft 114, such that rotation of the forward gear 112 causes thetransfer gear 116 to rotate as well. The transfer gear 116 may mesh witha sensor shaft gear 118, disposed on a sensor gear shaft 120. As theforward gear 112 rotates, so will the sensor shaft gear 118 and thesensor gear shaft 120. Use of a gear assembly may allow for placement ofan attached potentiometer 122 in a location that is off-center from thecentral rotational axis of the handle distal section 30, which mayadvantageously allow for a central placement of other internalstructures (e.g., irrigation conduit, optical fiber bundle, electronicflex cable, or other electronic components).

As in the example embodiment in FIG. 8, the sensor gear shaft 120 mayinclude a splined, or keyed (e.g., a D-shaped) portion. The keyedportion may operatively engage with one or more rotationalpotentiometers 122. In the example embodiment in FIG. 8, there are tworotational potentiometers 122. The potentiometers 122 may be mounted onor otherwise attached to a mounting element, or a part of a printedcircuit board in the handle as described in reference to FIG. 96. Thepotentiometers 122 each include a keyed (e.g. D-shaped) void with whichthe corresponding keyed portion of the sensor gear shaft 120 mates. Asthe sensor gear shaft 120 rotates, the electrical resistance of thepotentiometer(s) 122 will vary proportionately. Since the resistancewill predictably change with the amount of rotation of the sensor gearshaft 120 the measured resistance of the potentiometer(s) 122 may beused to determine the amount of rotation that has taken place betweenthe handle proximal section 16 and the handle distal section 30 (and byextension, the insertion section 14).

In some embodiments, the housing of each potentiometer 122 may bemounted to elements of the housed handle electronics section 80 (orother elements attached to the handle distal section 30), and thusimmobilized relative to the handle distal section 30 (and by extensionthe insertion section 14), while the shaft or rotating hub of thepotentiometer 122 is connected to the handle proximal section 16. Inother embodiments, the housing of the potentiometer 122 may beimmobilized relative to the handle proximal section 16, while its shaftor rotating hub may be connected to elements of the handle distalsection 30 or the handle electronics section 80.

The example embodiment in FIG. 8 includes two rotational potentiometers122 stacked together, and offset rotationally from one another. In analternate embodiment, the potentiometers 122 may be spaced apart fromeach other, but share a common rotational axis (e.g., the wipers of bothpotentiometers 122 are caused to move by a common shaft). Thisarrangement permits a controller receiving electrical resistance valuesfrom both potentiometers 122 to compute the degree of rotation of asensor shaft (and ultimately of components at the distal end of theendoscope) with a desired accuracy through 360 degrees of rotation, thushelping to eliminate computational “blind spots” in measuring therotation of the components at the distal shaft (e.g., a camera) of theendoscope. Any blind spot created by the position of a wiper of onepotentiometer 122 at the end of its range of motion may be compensatedfor by a wiper of a second potentiometer 122 whose position is not atthe end of its range of motion. In alternative embodiments, more thantwo rotationally offset potentiometers 122 may be used. The rotationaloffset between the potentiometers 122 may be 180 degrees forcomputational simplicity, but other angular offsets may be used toachieve the same result, as long as the rotational offset allows anyblind spot created by one potentiometer 122 to be overlapped by afunctional range of another potentiometer 122. In alternativeembodiments, the gearing ratios between the forward, transfer, andsensor shaft gears 112, 116, 118 may vary, depending on the degree ofprecision desired in measuring rotation, the sensitivity of thepotentiometers 122, and other factors. In alternative embodiments, therotation sensing assembly 150 may use belts rather than one or more ofthe gear assemblies. For example, the transfer gear 116 and sensor shaftgear 118 may be replaced by a belt. Other rotation to rotationarrangements known in the art may also be used. In some embodiments, theforward gear shaft 114 may include a keying feature (e.g., a D-shapedportion) which operatively engages the potentiometers 122 directly.Rotation sensors other than potentiometers 122 may also be used.Alternative embodiments may include rotation sensors such as, a rotaryencoder, a rotary variable differential transformer, or other encodingdevices. In embodiments using a rotary encoder, the encoder may be agray encoder, magnetic encoder (see e.g., FIG. 9B), optical encoder,etc.

In an embodiment, the sensor gear shaft 120 may not extend to the shaftbearing section of a shaft support member 63. Rather, the rotationsensing assembly 150 may be supported by the rotation sensor holder 110.Among other benefits, this arrangement allows for an unlimited degree ofrotation of the handle distal section 30 relative to the handle proximalsection 16. Additionally, as would be appreciated by one of skill in theart, it allows for components a of rotation sensing assembly 150 to belocated in an off-center position. This may provide benefits duringassembly. For example, it may simplify routing of an irrigation line 434(see FIG. 96), power cable 432 (see FIG. 96), etc.

In other embodiments, the shaft support member 63 and potentiometers 122may be directly connected by a shaft. A shaft splined or keyed on adistal end may extend from the shaft bearing section of the shaftsupport member 63 and extend through a corresponding splined or keyed(e.g., D-shaped) void in the potentiometers 122. Since the shaft supportmember 63 may be fixed relative to the handle proximal section 16,rotation of the distal handle section 30 relative to the handle proximalsection 16 will vary the resistance measured by the potentiometers 122.As mentioned above, since the resistance will predictably change withrotation of one handle section relative to the other, the resistancemeasurement may be used to determine the amount of rotation achieved bythe handle distal section (and ultimately, the distal end of theendoscope or camera assembly 350 shown, for example, in FIG. 21).

In other embodiments, the rotation sensing assembly 150 may include arange finder which may be disposed on the housed handle electronicssection 80 (see FIG. 7A). The interior walls of the handle proximalsection 16 (see FIG. 4) may include a variable-thickness orvariable-height raised surface that wraps around most or all of the 360°of the interior wall of the handle proximal section 16, and varies inthickness or height in a pre-determined manner along its circumferentialpath. As the handle proximal section 16 and handle distal section 30rotate relative to one another, the range finder may provide acontroller with a signal that varies according to the distance read bythe range finder to the varying surface (either its varying thickness orheight). The signal may be correlated to the thickness/height ordistance measured by the range finder relative to a pre-determined baseposition in which the surface has a specified thickness or height and iscorrelated to a specified angular rotation of the handle distal section30 relative to the handle proximal section 16. This distance may becompared to a previous distance to thereby determine the amount ofrotation that has occurred. The range finder may be any type of rangefinder (e.g. a mechanical position sensor, a sonic range finder, laseror other optical range finder, etc.).

In yet another alternative embodiment, an optical mouse like sensorarrangement may be used. The sensor may be mounted on one of the housedhandle electronics section 80 or handle proximal section 16 and may beconfigured to track movement of the other of the housed handleelectronics section 80 or handle proximal section 16. In suchembodiments, the amount and direction of movement sensed by the sensormay be used to determine the amount and direction of rotationaldisplacement that has occurred. In some embodiments, the surface trackedby the sensor may have a reference grid, number of unique indicators,pattern, markings, or other differentiating features, which allow sensordetermination of rotational orientation upon start up. Other varietiesof rotation sensing assemblies 150 known to those skilled in the art mayalso be used in various embodiments.

As shown in FIG. 8, the rotation sensor holder 110 of the handle distalsection 30 may be shaped such that when the two separate parts 30 a and30 b of the handle distal section 30 are coupled together, the rotationsensing assembly 150 may be captured between the two separate parts 30 aand 30 b. Each side of the rotation sensor holder 110 may include aforward gear shaft trough 124 and a sensor gear shaft trough 126. Whenassembled the forward gear shaft trough 124 and the sensor gear shafttrough 126 may act as bearing surfaces respectively for the forward gearshaft 114 and the sensor gear shaft 120. Each side of the rotationsensor holder 110 may also include a holder void 128. The holder void128 may be sized and shaped such that the transfer gear 116, sensorshaft gear 118, and potentiometers 122 may fit within the rotationsensor holder 110 when the handle distal section 30 is fully assembled.

FIG. 9A shows a partially assembled view of the handle 12 of theendoscope 10. Only the handle bottom section 22 of the handle proximalsection 16 is shown in FIG. 9A. As shown, a part of the handle bottomsection 22 of the handle proximal section 16 has been cut away.Additionally, in the embodiment shown in FIG. 9A, the handle distalsection 30 is assembled from two separate parts 30 a and 30 b (see FIG.8). One of the halves (30 b) of the handle distal section 30 has beenremoved in FIG. 9A for clarity. (In the embodiment shown in FIG. 9A, thehandle distal section 30 is assembled from two separate parts 30 a and30 b (see, e.g. FIG. 8). One of the halves (30 a) of the handle distalsection 30 has been removed in FIG. 9A for clarity). The housed handleelectronics section 80 may be located inside the handle proximal section16. The external handle distal section 82 extends beyond the handleproximal section 16 and is exposed to the environment.

As described above, the rotation sensing assembly 150 is disposed withinthe rotation sensor holder 110. As shown, the forward gear 112 of therotation sensing assembly 150 may mesh with the annulus gear formed bythe toothed projection 62 and toothed projection 64 (best shown in FIG.5). In such embodiments, when the handle 12 is fully assembled, anyrotation of the handle distal section 30 in relation to handle proximalsection 16 causes the forward gear 112 to rotate since it meshes withthe annulus gear formed by the toothed projection 62 and the toothedprojection 64. This rotation may then be translated through the rest ofthe rotation sensing assembly 150 allowing the rotation to be measuredby the rotation sensing assembly 150. In a preferred embodiment, theoverall gear ratio may be approximately 1:1.

Alternatively, rather than gear elements, the handle proximal section16, similar to that shown in FIG. 4, may comprise a keyed shaft orpartially keyed shaft, affixed to the shaft support section 65 of theshaft support member 63. The keyed portion of the shaft may be arrangedto mate with the hub of one or more potentiometers 122, which are heldin rotation sensor holder 110. Thus as the handle distal section 30 isrotated relative to the handle proximal section 16, the wiper of the oneor more potentiometers 122 is able to convert the relative positions ofthe handle distal section 30 and proximal section 16 into an electricalresistance value usable to determine rotational orientation.

Referring now to FIG. 9B, an alternative embodiment of an example handle12 of an endoscope 10 including a rotation sensing assembly 150 isdepicted. Only the handle first half-shell 21 is shown in FIG. 9B tomake the interior of the handle 12 visible. Additionally, a portion ofthe handle first half-shell 21 has been cut away.

Shown in FIG. 9B is an enclosure 431 for a printed circuit board (PCB)that comprises electronic components for processing image data from theimage sensor at the distal end of the shaft, and optionally forproviding power to light sources (e.g. LED's) at the distal end of theendoscope shaft. The enclosure 431 is an optional structure, because thePCB may also or additionally be encased in a water resistant material.The water resistant material may be any suitable potting material, suchas, for example, Parylene, or other chemical vapor deposited polymer tocoat and protect the individual electronic components mounted on thePCB. Also shown is a magnet 51 which is included in the handle firsthalf-shell 21. The printed circuit board within enclosure 431 mayinclude one or more magnetic position sensors 430 g such as a Halleffect sensor or sensor array. As mentioned above in relation to FIG. 6,each of the handle first half-shell 21 and handle second half-shell 23may include a magnet 51 or multiple magnets 51 in some embodiments. Inan embodiment, two magnets 51 are positioned opposite each other in eachhalf of the handle 16. As handle proximal section 16 is rotated relativeto the handle distal section 30 the magnet(s) 51 move relative to theenclosure 431 and the enclosed printed circuit board. The magneticsensor(s) 430 g on the printed circuit board can detect the relativepositions of the magnet(s) 51 through variations in magnetic fieldstrength and location as the magnets move relative to the printedcircuit board. In an embodiment, a single tri-axis position sensor isused for sensing the magnets 51. Data from the one or more sensors canbe transmitted to a controller or processor for conversion of the sensordata into rotational position of the handle proximal portion 16 relativeto the handle distal section 30 (and relative to the position of theoptical sensor or camera at the distal end of the endoscope shaft).Thus, a displayed image of the field of view of the camera can berotated to any desired orientation without actually moving the camera atthe distal end of the endoscope shaft.

Referring now to FIG. 10A, in an embodiment, the insertion section 14 ofan endoscope 10 includes a conduit 157 through which operations orfunctions may be performed. In industrial or medical applications, thisconduit 157 may be used to pass instruments to manipulate objects at theend of the insertion section 14 (instruments such as graspers, forceps,clamps, wire baskets, dilators, knives, scissors, magnetic pickups,etc.). Fluid (gas or liquid) may also be passed to/from an externalsource from/to the space within which the insertion section 14 isplaced. In medical applications, such a conduit 157 may be used toinsufflate a body cavity with a gas, evacuate gas from a body cavity,irrigate a space with liquid, or aspirate liquid and/or suspendedparticulates from a space. The conduit 157 optionally may carry utilitycomponents such as light transmission, information transmission, powertransmission, and mechanical control components, saving space within theinsertion section 14 and helping to reduce the overall diameter of theinsertion section 14. A light transmission component may include, forexample, a fiberoptic bundle, ribbon, light pipe, light projectionelement, and/or the like. An information transmission component mayinclude, for example, an electrical cable bundle or ribbon connecting animager or image sensor at the end of the insertion section 14 to animage processing unit situated in the handle 12 or external to theendoscope 10. Such a cable may also provide power to the image sensor.Mechanical control components may include, for example, pushrods, pullwires, etc. to control the movement of an element near the end of theinsertion section 14. This may include, for example, an activelyflexible distal segment of the insertion section 14 that can be activelyflexed by the use of the mechanical control component(s) extending fromthe handle 12. It may also include, for example, a rotatable camera orcamera mount at the end of insertion section 14 that can be activelymoved by the use of the mechanical control component (s) extending fromthe handle 12.

In an embodiment, a fluid carrying conduit 157 within the insertionshaft or section 14 is configured to enclose utility components of theendoscope 10, such as, for example, fiberoptic bundles, communicationcables and mechanical actuators. In a further embodiment, the conduit157 may be in fluid communication with a camera assembly 350 (see, forexample, FIG. 21) at the distal end of insertion shaft 14. The cameraassembly 350 may include a camera sensor or imager having connections toa communications cable. In this case, the camera sensor andcommunications cable connections, and the internal components of anyassociated lens assembly may be sealed against exposure to liquidspresent within the conduit 157. Allowing a camera assembly 350, lensassembly, communications cable, mechanical actuators (e.g. pull-wires)and fiberoptic cables or bundles to be exposed to a ‘wet’ conduit may befeasible if at least a portion of the endoscope 10 is configured to be asingle use device, i.e., disposable after use in a medical procedure.Any technical challenges in adequately sterilizing intra-conduitcomponents are thus obviated.

Some components of the endoscope 10, particularly electronic componentslocated within the handle section 12, preferably should be kept dry. Abulkhead or barrier element 159 between the conduit 157 of the insertionsection 14 and the interior of the handle 12 may allow passage ofcomponents from the handle 12 to the insertion section 14 conduit 157(represented in FIG. 10A by line segments 155 and referred to aspass-through components), while also inhibiting infiltration of fluidfrom the conduit 157 into the interior space of the handle 12. Thebarrier 159 may comprise passageways (holes, slits, etc.) through whichpass-through components 155, such as the utility components describedsupra, may pass from the handle 12 to the conduit 157 of the insertionsection 14. The passageways may be formed to provide a relatively tightfit around the outside surface of the pass-through components 155. Insome embodiments, elastomeric gaskets, O-rings, or other similarelements may further aid in inhibiting fluid infiltration from theconduit 157 of the insertion section 14 to the interior spaces of thehandle 12. The barrier 159 may comprise a wall separating a junctionregion between the handle 12 and a proximal end of the insertion section14. The junction region may be near an area where the conduit 157connects to a conduit port providing an external fluid connection forthe conduit 157. The barrier 159 may alternatively comprise a blockthrough which a routing channel connects a utility hole communicatingwith the conduit 157 on a first side of the block with one or morefeatures (e.g. a conduit port) on a second side of the block oppositethe first side of the block, or on a third side of the block (which insome embodiments, may be roughly perpendicular to the first side of theblock). Passageways for cables, ribbons, wires, pushrods or othercomponents from the handle 12 may be formed on the second side of theblock, opposite the first side of the block and may be aligned with theutility hole of the block. The conduit 157 may be formed from a sheath(such as inner sheath 312 of FIG. 17) connected or attached to thehandle 12 of the instrument. In some embodiments, the pass-throughbarrier 159 between the handle 12 and a sheath of the insertion section14 may comprise a sheath mount, which serves to support the sheath ofthe insertion section 14 near its origin proximally at the handle 12,and to attach or connect it to the handle 12. In some embodiments, theinsertion section 14 may comprise a cannula within which the sheath maybe positioned. The cannula may be mounted to the handle 12 via adisconnect feature, allowing the cannula to remain in situ while theendoscope 10—including handle 12 and sheath—can be withdrawn from asite.

Referring now to FIG. 10B, in some embodiments, the barrier 159 mayinclude a flexible or elastomeric member 153. One or more pass-throughcomponents 155 may extend through the flexible member 153 of the barrier159 to the conduit 157 of the insertion section 14. In some embodiments,one or both of the entry and exit points of the pass-through component155 in the flexible member 153 may be sealed with a sealing member oragent 151. The sealing member or agent 151 may prevent the flow of fluidbetween the conduit 157 and the handle 12. The sealing member or agent151 may also hold the pass-through component 155 such that it isprevented from moving relative to its entry and/or exit point in theflexible member 153. Any suitable sealing member or agent 151 may beused, such as, for example, a glue, epoxy, or other adhesive. In otherembodiments, the pass-through components may be solvent bonded, heatbonded, etc. to the flexible member 153. In yet other embodiments, theflexible member 153 may be formed in place around the pass-throughcomponents 155 during manufacture such that a seal is created betweenthe pass-through components 155 and the flexible member 153.

As the pass-though components 155 move (e.g. actuating pull wires forrotation of a camera assembly) the flexible member 153 may stretch orflex since the pass-through components 155 are fixed and prevented fromdisplacing relative to their entry and exit point in the flexible member153 due to the sealing member or agent 151. Thus, ingress or leakage offluid into the handle from the conduit 157 may be substantially ortotally inhibited while allowing the pass-through components 155 to moveback and forth. Pass-though components 155 which remain in fixedposition and do not displace need not necessarily pass though theflexible member 153. Instead, these components may pass through a rigidportion of a barrier 159 which may or may not be coupled to the flexiblemember 153. The flexible member 153 may be constructed, for example, asan elastomeric member, a flexible membrane, flaccid wall, a bellows-likearrangement, diaphragm, etc.

A barrier 159 described in relation to FIG. 10A is shown in FIG. 11A andcan also be referred to as an inner sheath mount 160. As shown, theinner sheath mount 160 includes a distal section 161 a and a proximalsection 161 b, separated in FIG. 11A from one another to reveal theinterior of the inner sheath mount 160. As shown the distal section 161a may include notches 162 on each side of the distal section 161 a. Asshown in the example embodiment in FIG. 11A, a portion of an interiorface 164 (when assembled) of the distal section 161 a may be recessed.An irrigation or suction routing channel 166 may also be recessed intothe distal section 161 a of the inner sheath mount 160. As shown, theirrigation routing channel 166 is located within the recessed face 164.The irrigation routing channel 166 may be in communication on a firstend with a utility hole 168. In the example embodiment, the utility hole168 may be located substantially near the center of the distal section161 a, within the recessed face 164 (although in other embodiments, theutility hole 168 need not be centered).

The proximal section 161 b of the inner sheath mount 160 may alsoinclude notches 170 in its right and left sides similar to the notches162 recessed into distal section 161 a. The notches 170 may extend allthe way through the proximal section 161 b. The notches 162 and 170 ofthe inner sheath mount 160 may be sized to accept a projection of thehandle distal section 30, which may help to hold the inner sheath mount160 in place when the endoscope 10 is fully assembled.

The proximal section 161 b may also include a raised portion 172 of aninterior face (when assembled). As shown, the raised portion 172 is ofsimilar outer dimensions as the recessed face 164 in the distal section161 a. When assembled, the raised portion 172 may be pressed into therecessed face 164 to couple the distal section 161 a and proximalsection 161 b together. In some embodiments, glue or another suitableadhesive between the recessed face 164 and raised portion 172 may beused to bind the proximal section 161 b to the distal section 161 a.This may also serve to create a hydraulic seal between the twocomponents.

The proximal section 161 b may include a number of other features. Asshown, the proximal section 161 b includes an irrigation or suctionpassage 174. The irrigation or suction passage 174 may be situated toalign with a second end of the irrigation routing channel 166 when theproximal section 161 b is mated to the distal section 161 a. When theendoscope 10 is in use, irrigation or suctioned fluid may flow betweenthe utility hole 168 and irrigation passage 174 via the irrigationrouting channel 166.

As shown in the example embodiment in FIG. 11A, the proximal section 161b of the inner sheath mount 160 may include a sheath mount slit 176. Asshown, the sheath mount slit 176 may be oriented horizontally(orientation refers to that shown in FIG. 11A) and located in theproximal section 161 b of the inner sheath mount 160, roughly alignedwith the utility hole 168. The sheath mount slit 176 may be orienteddifferently in alternate embodiments. In the example embodiment in FIG.11A, the sheath mount slit 176 extends through the entire proximalsection 161 b at an angle substantially perpendicular to the plane ofthe interior face (when assembled) of the proximal section 161 b.

The proximal section 161 b of the inner sheath mount 160 may alsoinclude a number of orifices 178. In the example embodiment in FIG. 11A,the orifices 178 are small diameter holes which extend through theentire proximal section 161 b, and can be used to allow passage of pullor push cables or wires from within the handle to the distal end of theendoscope 10. The proximal section 161 b may also include a fiber opticspassageway 179. In the example embodiment, the orifices 178 and fiberoptics passageway 179 are angled perpendicular to the interior face(when assembled) of the proximal section 161 b. In alternateembodiments, the orifices 178 and fiber optics passageway 179 may beangled differently or may have a different diameter. As shown, theorifices 178 are arranged around the sheath mount slit 176. When theinner sheath mount 160 is fully assembled, the sheath mount slit 176 andorifices 178 are aligned with the utility hole 168 of the distal section161 a.

In alternative embodiments, the shape, location, dimensions, etc. ofsome features of a bulkhead, pass-through barrier or inner sheath mount160 may differ. A pass-through barrier or inner sheath mount 160 mayinclude additional features or may omit certain features. In someembodiments, there may be a larger or smaller number of orifices 178. Insome embodiments, the orifices 178 may not be arranged in the spatialarrangement shown in FIG. 11A. There may be more than one irrigationpassage 174. In some embodiments, the inner sheath mount 160 may beassociated with or include a gasket to further inhibit fluidinfiltration into sensitive areas within the handle of the endoscope.

The handle electronics section 80 (see, e.g., FIG. 7A) is configured toenclose mechanical and electronic components that are preferablyprotected against excessive amounts of fluid infiltration. (Smallamounts of fluid or moisture need not inhibit proper mechanical orelectrical operation of the endoscope, particularly if the electroniccomponents are coated with a moisture resistant film). The handle distalexternal section 82 (the pivot control housing), is configured to housethe pivot control structures and actuation cables for controllingmovement of a camera assembly in the distal end of the endoscope shaftor insertion shaft, and may be exposed to liquid with relatively minimaleffect on the operation of the endoscope. Therefore, it is moreimportant to maintain a liquid seal between the handle electronicssection 80 and the handle distal external section 82. A bulkhead orpass-through barrier such as sealing member 210, shown in FIGS. 13 and14 may be constructed to provide a tight seal (e.g. elastomeric seal)around an electronic flex cable, an optical fiber bundle, or otherstructures that must pass from the distal end of the endoscope to itsproximal end before exiting. On the other hand, a pass-through barriersuch as inner sheath mount 160, shown in FIGS. 11A and 14, may allow fora lesser seal, particularly as it may apply to any pull wires or cablesthat pass from the pivot control structure to the distal end of theendoscope shaft. Any fluid infiltration into the handle distal section82 may be allowed to exit the housing through one or more drain holes orpassages built into a dependent part of the housing, such as forexample, passage 108 shown in FIG. 8.

In an alternate embodiment, a pass-through barrier 159 (see FIG. 10B)between the handle distal section or pivot control housing 82 and theshaft of the endoscope may comprise a fully sealed structure that yetpermits movement of the pull cables or actuation cables that extend fromthe pivot control housing to the distal end of the endoscope shaft. Forexample, the pass-through barrier may comprise a flexible (or floppy)diaphragm, a pleated elastomeric diaphragm, accordion-structured rubberboot, bellows structure, or otherwise displaceable diaphragm that isattached at its periphery to the housing, that forms a fluid-tight sealaround any structures passing through it near its central region, andwhose central region may freely move back and forth distally andproximally to permit free movement of any pivot control cables passingtherethrough. With a more complete seal at this portion of theendoscope, the need for a secondary seal between the pivot controlhousing and the handle electronics section 80 may be reduced oreliminated.

FIG. 11B depicts an alternative embodiment of a bulkhead or pass-throughbarrier 159 which comprises a flexible member 153. As shown, thepass-through barrier 159 includes a rigid structure 167 and a flexiblemember 153. A rigid portion or structure 167 may act as a frame to whichthe flexible member 153 is attached or fused. In some embodiments, adual molding process may be used to couple the flexible member 153 andthe rigid portion or structure 167 together during manufacture. Therigid structure 167 may include one or more mating features 173 whichmay be sized to mate with a cooperating mating feature of the handledistal section 30 (see, e.g. FIG. 15). In some embodiments, theinteraction of the mating feature(s) 173 with the cooperating portion ofthe handle distal section 30 (see, e.g. FIG. 15) may create a sealbetween the pass-through barrier 159 and the handle distal section (see,e.g., FIG. 15).

Referring now also to FIG. 11C, to facilitate the creation of such aseal, a gasket member 163 may be included around the periphery of thepass-through barrier 159. Such a gasket member 163 may be placed alongthe outer edges 165 (FIG. 11B) of the pass-through barrier 159.Alternatively, a dual molding process may be used to attach the gasketmember 163 to the pass-through barrier 159 during manufacture. Thegasket member 163 may completely encircle the rigid structure 167, andmay be formed from a compressible or elastomeric material, such as,e.g., Metaprene®.

Still referring to FIG. 11B and FIG. 11C, the flexible member 153includes a number of pass-through elements. A number of orifices 178 areincluded in the example flexible member 153. Additionally, the flexiblemember 153 may include an optional illumination or fiber optic passage179. Such an illumination passage 179 may not be needed in embodimentsin which illumination is provided by one or more LEDs at the distal endof the endoscope shaft, for example. Additionally, a slit or slot 177may be included in the flexible member 153. In the example embodiment,the slit 177 extends from the flexible member 153 through the rigidstructure 167 to the edge of the pass-through barrier 159.

Pass-through elements and passages in the pass-through barrier 159 mayalso be disposed in the rigid frame structure 167 of the pass-throughbarrier 159 as well. It may be desirable, for example, that pass-throughelements or passages associated with fixed or non-displacing componentsbe disposed in the rigid structure 167 of the pass-through barrier 159.In the example embodiment a rigid structure passage 169 is shownproviding a passageway through the rigid structure 167.

A conduit attachment site or port 256 may also be included on apass-through barrier 159. As shown, the conduit attachment port 256projects from the rigid structure 167 and optionally includes a barbedfitting over which a flexible tube or conduit may be secured. A conduitattachment site 256 may include an interior lumen which extends throughthe pass-through barrier 159. In the example embodiment shown in FIG.11B the interior lumen is an irrigation or suction passage way 174through which fluid may be transferred from one side of the pass-throughbarrier 159 to the other.

Referring now also to FIG. 11D, when assembled, various pass throughcomponents 155 may be passed through the orifices 178, passage 179 andslit 177 in the pass-through barrier 159. Once these pass throughcomponents 155 have situated in the pass-through barrier 159, a sealingmember or agent 151 optionally may be applied to one or both of theentry and/or exit points of the pass through components 155 in thepass-through barrier 159. In the example embodiment, the sealing memberor agent 151 is fixative such as adhesive though in other embodimentsany suitable sealing member or agent may be used. The sealing member oragent 151 may prevent fluid communication through the pass-throughelements in the pass-through barrier 159. Additionally, when applied onthe flexible member 153 it may fix pass through components 155 such thatmay not displace relative to their entry and exit point in the flexiblemember 153. As a result, in this case displacement of the pass-throughcomponents 155 will cause the flexible member 153 to move back and forthas well.

FIG. 12 shows an example exploded view of an embodiment of a pivotcontrol structure 100. The pivot control structure 100 may controlpivoting of a structure. The structure may for example be a cameraassembly 350 (see FIG. 21) at a distal end of the insertion section 14(see FIG. 3A). In alternate embodiments, the pivot control structure 100may be used to instead or additionally control the flexing of a flexiblesection of the insertion section 14. Some embodiments of the pivotcontrol structure 100 may include gearing, a motor, multi-bar linkage,dials, etc. that differ from the embodiment disclosed below.

The example pivot control structure 100 in FIG. 12 is shown in anexploded view. The finger contact 98 detailed above is shown separatedfrom the pivot control structure 100. As shown, the bottom face of thefinger contact 98 optionally may include a number of peg projections180. In the example embodiment shown in FIG. 12, there are four pegprojections 180 which are generally cylindrical in shape (number andshape of peg projections may differ). The finger contact 98 additionallyincludes a finger contact slot 182 situated in the under-surface of thefinger contact 98.

Below the finger contact 98, an example embodiment of a pivoting portion184 of the pivot control structure 100 is shown. The top of the pivotingmember 184 of the pivot control structure 100 may include a slider 186.Projecting from the center of the slider 186 is a finger contact post188 arranged to mate with finger contact slot 182. Optionally, fingercontact peg holes 190 flank the finger contact post 188 on each side ofthe finger contact post 188. When the finger contact 98 is attached tothe pivot control structure 100 the finger contact slot 182 may be slidonto the finger contact post 188 on the slider 186. Additionally, whenassembled, the peg projections 180 of the finger contact 98, if present,may be seated in the finger contact peg holes 190 of the slider 186.

A pivot control structure 100 may interact with one or more feature ofthe endoscope allowing it to be locked or held in a desired orientation.As shown, the bottom face of the slider 186 of the pivoting member 184optionally may include one or more catch bars or detent elements 192. Inother embodiments, multiple catch bars 192 may be disposed along thebottom of the slider 186, arranged to engage with opposing raisedfeatures or ridges 94 on the handle 12.

The catch bars or detent elements 192 may interact with the raisedfeatures or ridges 94 of the slide button recess 92 of the handle raisedportion 32 described above (best shown in FIG. 7A). As the pivot controlstructure 100 is displaced by the user, the spaces between ridges 94 mayact as detents in which the catch bars 192 of the slider 186 may be“parked”. This helps to prevent drifting or movement of the pivotcontrol structure 100 once a user moves it to a desired position andreleases it. It may also help to ensure that the pivot control structure100 is not accidentally displaced during use of the instrument. Inalternative embodiments, and as mentioned above in relation to FIG. 7C,in some embodiments, the pivot control structure 100 may include arms 97which act as catch bars or detent elements 192.

As shown, the pivoting member 184 of the pivot control structure 100includes a curved inner shield 194. The inner shield 194 is tiered belowthe slider 186, and under the handle housing when assembled. A post 196may span the distance between the top face of the inner shield 194 andthe bottom face of the slider 186. In some embodiments, the catch bars192 may be located on the top of the inner shield 194. In suchembodiments, the ridges 94 described above may be located on theinterior wall of the housing of the handle distal section 30 such thatthe ridges 94 may form detents for the catch bars 192 on the innershield 194. As described above, this allows the pivot control structure100 to be “parked” in a desired position.

Extending from the bottom face of the inner shield 194 may be a pivotarm 198. In the example embodiment, the pivot arm 198 includes twomechanical cable attachment points or holes 202. One hole 202 issituated on one side of a pivoting shaft 204, while the second hole 202is situated on the other side of pivoting shaft 204. In the illustratedembodiment, forward movement of slider 186 causes a mechanical cableconnected to the lower hole 202 to be retracted proximally, while aftmovement of slider 186 causes a mechanical cable connected to the upperhole 202 to be retracted proximally. In order to accommodate arelatively unimpeded passage of a fiberoptic or electrical cable fromthe proximal end of the handle to the distal end of the handle, thepivot arm 198 may be, for example, notched over its pivot shaft 204, sothat a passing cable may rest freely on the pivot shaft 204 (or aconcentric sleeve or hub surrounding the shaft 204). Such an arrangementwould allow passage with minimal displacement laterally or vertically.

Referring now to both FIGS. 12 and 14, the pivot arm 198 is constructedto have a laterally displaced section 199 encompassing pivoting region200 and pivot shaft 204. Thus a hub or sleeve encompassing pivot shaft204 (when assembled) is shown to serve as a bearing surface upon which apassing cable 250 may rest. A lower portion of pivot arm 198 extendsdownward from a location beneath the hub or sleeve of pivot shaft 204.In some embodiments, the lower portion of pivot arm 198 optionally maybe vertically aligned with the upper portion of pivot arm 198, so thatmechanical cables connected to points or holes 202 are also alignedvertically. In other embodiments, one or more cables (e.g., cable 250)may travel around (or through) a hub of pivot shaft 204 in a variety ofother ways, so that its path is minimally obstructed by the pivot arm198 of the pivot control structure 100.

Optionally, a secondary pass-through seal provides an additional barrierbetween fluid that may infiltrate into the housing of the handle distalsection 30 and the housing of handle proximal section 16, in whichelectronics section 80 may be housed. The seal may include orifices,holes or slits through which components such as though not limited to,fiberoptic bundle, electronic cable and/or fluid conduit tubing maypass. The holes or slits may be sized to provide a snug fit over thesecomponents as they pass through the seal. In an embodiment, thesecondary pass-through seal is formed from a rubber or other elastomericmaterial to enhance its fluid sealing characteristics. In someembodiments, for example, those which include a pass through barrier 159which includes a flexible member 153, no secondary pass-through seal maybe included. In such embodiments, the electronics section 80 and theexternal handle section 82 may be the same volume or connected volumes.

FIG. 13 shows an example embodiment of a secondary seal, i.e. sealingmember 210. The sealing member 210 may be roughly rectangular in shapeas shown in FIG. 13. As shown in FIG. 13, one end of sealing member 210may be of a first (e.g. a rectangular) shape, while a second end ofsealing member 210 may be of a second shape (e.g. have rounded edges orbe rounded). This may provide an advantage during assembly to ensurethat the sealing member 210 is mounted in the proper orientation. Thesealing member 210 may include a number of orifices. In the exampleembodiment, the sealing member 210 includes a fiberoptic bundle (e.g.,an illumination fiber) orifice 212, a flex cable (i.e., electroniccable) orifice 214, and a fluid tubing (e.g., an irrigation line)orifice 216. In the example embodiment shown in FIG. 13 the illuminationfiber orifice 212, flex cable orifice 214, and irrigation line orifice216 extend through the entire sealing member 210. The illumination fiberorifice 212 has a relatively small diameter to match the diameter of afiber bundle or light pipe. The flex cable orifice 214 is a slit,matching the size and shape of an electronic flex cable. The irrigationline orifice 216 is cylindrical and has a diameter larger than that ofthe illumination fiber orifice 212. The illumination fiber orifice 212,flex cable orifice 214, and irrigation line orifice 216 extend throughthe sealing member 210 at an angle that is substantially perpendicularto the front face (relative to FIG. 13) of the sealing member 210. Inalternative embodiments, the orifices in the sealing member 210 maydiffer in number, size or shape. In some embodiments, the sealing member210 may include an additional hole for wiring to the button 90, forexample.

As shown in the example embodiment in FIG. 13, the sealing member 210may also include a number of gasket arms 218. In the example embodimentin FIG. 13, the gasket arms 218 project away from the top and bottomfaces of the sealing member 210 near the back edge of the sealing member210. As shown, there may be two gasket arms 218. In some embodiments,the gasket arms 218 may be straight. In the example embodiment, thegasket arms 218 include two straight sections connected by an arcuatesection which bends the gasket arms 218 away from the sealing member210.

FIG. 14 shows an example embodiment of one half (30 a) of the handledistal section 30. As shown, the inner sheath mount 160, pivot controlstructure 100 and the sealing member 210 are assembled and placed withinthe shown half (30 a) of the handle distal section 30. A flex cable 250(e.g., flexible electronic communications/power cable) is also shown. Inthe example embodiment shown in FIG. 14, the distal section 161 a of theinner sheath mount 160 includes a sheath mounting hub 252. The sheathmounting hub 252 extends distally along the same axis as the utilityhole 168 (see FIG. 11A). In the example embodiment, the sheath mountinghub 252 may be hollow and substantially cylindrical. The inner diameterof the sheath mounting hub 252 optionally may be approximately equal toor somewhat larger than the diameter of the utility hole 168. In theexample embodiment, a sheath mount mounting tab 254 projects superiorlyfrom the outer surface of the sheath mounting hub 252. The sheath mountmounting tab 254 is located next to the face of the insertion side piece160 a from which the sheath mounting hub 252 projects. The mounting tab254 may serve to properly orient a sheath (e.g. inner sheath 312 shownin FIG. 17) as it is mounted onto the sheath mounting hub 252, andoptionally may also serve as a locking member to secure a sheath to thesheath mounting hub 252 and sheath mount 160.

In other embodiments, the sheath mount tab 254 may be disposed on theinside surface of the sheath mount hub 252. This may be desirablebecause it obviates the need to nest the inner sheath mount hub 252inside of a sheath removing a restriction in the diameter of the conduitof the sheath. Consequentially, a higher flow rate through such aconduit may be achieved. Alternatively, a sheath mount nub 254 may notbe included in some embodiments. The sheath may instead be oriented andsecured to a sheath mount hub 252 in any suitable fixture (not shown).

As shown the flex cable 250 extends through the inner sheath mount 160.The flex cable 250 passes through the sheath mounting hub 252 into thedistal section 161 a of the inner sheath mount 160. The flex cable 250is also routed through the sheath mount slit 176 of the proximal section161 b.

The proximal section 161 b of the inner sheath mount 160 includes afluid conduit attachment site or port 256. The fluid conduit attachmentsite 256 may be a hollow, roughly cylindrical projection which extendstoward the right of the page (in relation to FIG. 14) from the proximalsection 161 b of the inner sheath mount 160. Tubing of an irrigationline 434 (see FIG. 96) may be slid over the outer surface of the fluidconduit port 256, which optionally may be barbed to aid in retaining aninstalled section of tubing. As shown, the right edge of the fluidconduit port 256 may be chamfered in a manner to also facilitate ease ofinstallation of a tubing segment to the port 256. Additionally, as shownin FIG. 14, the proximal end of the fluid conduit port 256 tapers to aslightly larger diameter than the rest of the port 256 surface. This mayact as a barb and help ensure that once attached, the tubing of anirrigation line 434 (see FIG. 96) is not easily dislodged. In analternative embodiment, the conduit port 256 may extend and be fittedinto an irrigation line orifice 216 of a sealing member 210. The barbedportion/attachment site for an irrigation line 434 may then be placed onthe sealing member 210.

The pivot control structure 100 may be pivotally coupled into the handledistal section 30 as shown in FIG. 14. As shown, the pivot shaft 204extends through the pivot shaft hole 200 in the pivot arm 198 of thepivot control structure 100. The end of the pivot shaft 204 (or of asurrounding hub) inserted into the far wall of the handle distal section30 may be seated in a pivot bearing 260 projecting from the inner wallof the handle distal section 30. When fully assembled, the opposite endof the pivot shaft 204 may similarly be seated in a pivot bearing 260projecting from the inner wall of the other half (30 b) of the handledistal section 30.

As shown in FIG. 14, the slider 186 and inner shield 194 of the pivotcontrol structure 100 may be offset from each other by the post 196 adistance slightly larger than the thickness of the walls of the handledistal section 30. The post 196 may extend through the pivot controlstructure notch 96 described above. The curvature of the slider 186 andinner shield 194 may be selected such that the slider 186 and innershield 194 may freely move fore and aft with input from a user withoutinterfering with the walls of the handle distal section 30 housing. Thelength of the pivot control structure notch 96 may determine the amountof pivotal displacement a user may create with input to the pivotcontrol structure 100.

In some embodiments, the walls of pivot control structure notch 96 mayexert a frictional force against the post 196. In such embodiments, thisfrictional force may allow the pivot control structure 100 to be“parked” in a position. In such embodiments, the walls of the pivotcontrol structure notch 96 may be made of a high friction material suchas rubber or other elastomeric material. In such embodiments, the pivotcontrol structure 100 may not need to include the catch bars 192 or theridges 94 described above.

The endoscope 10 may also include mechanical pivot actuators in the formof pull cables or wires, belts, or pushrods. An actuator may be anyelongate member, solid, braided, or otherwise extending from the handleof the endoscope 10 to a movable element at the distal end of theinsertion section. The elongate member may be flexible or substantiallyrigid. The elongate member may be round (as in the example of a cable),ovoid, relatively flat, or may have any other shape or cross section. Insome embodiments, the actuator may be a belt.

In an endoscope having a pannable camera or camera mount at or near thedistal end of the shaft or insertion section, the pannable camera orcamera mount may be rotated using pull wires or pushrods. In a pull wireembodiment, panning cables may be attached or connected to, or loopedthrough the cable attachment holes 202. In some embodiments, two panningcables may be attached to each cable attachment hole 202. In a preferredembodiment both ends of a single panning cable are attached to eachcable attachment hole 202 creating a loop. Alternatively, a single cablemay be looped through the cable attachment hole 202 at about itsmidpoint, the ends of the cable then being connected distally to therotatable camera or camera mount. The panning cables may extend from thecable attachment holes 202 in the pivot arm 198 and be routed throughone or more orifices 178 in the proximal section 160 b of the innersheath mount 160. The panning cables may then extend through the utilityhole 168 and through the conduit formed by the inner sheath, optionallyalongside the length of an electronic flex cable 250 and/or fiberopticbundle. By pivoting the pivot control structure 100, the panning cableor cables connected to one of the cable attachment holes 202 will bepulled, while the cable(s) connected to the other attachment hole 202will slacken. By attaching the panning cable or cables associated withone cable attachment hole 202 to one side of a pivot point and attachingthe panning cable or cables associated with the other cable attachmenthole 202 to the opposite side of the pivot point, the pivot controlstructure 100 may be used to selectively rotate a pivoting objectdistally in the insertion section of the endoscope. In otherembodiments, a similar cabling mechanism may be used to actively flex aflexible distal segment of the insertion section.

In some embodiments, the pivot arm 198 of the pivot control structure100 may be pivoted via gearing. In such embodiments, the finger contact98, finger contact post 188 (see FIG. 12), slider 186, vertical post196, and inner shield 194 may not be needed. At least a portion of auser input gear contained in the handle distal section 30 may projectout of the handle raised section 34. The user input gear may be rotatedabout a pivot axis disposed within the handle distal section 30. Thisrotation may be user-initiated via, for example, a user's finger orthumb. The user input gear may mesh with a pivot shaft gear disposedabout the pivot shaft 204 for the pivot arm 198 of the pivot controlstructure 100. In such embodiments, as the user input gear is rotated,the pivot shaft gear and pivot arm 198 are also caused to rotate, actingon the pivot actuators (e.g. panning, actuating or pull wires) asdescribed above. In some embodiments, there may be an intermediary gearor any number of intermediary gears between the user input gear and thepivot shaft gear to provide any desired gear reduction to meetprecision-of-movement and ergonomic requirements.

In other embodiments, the pivot arm 198 may be caused to rotate via anelectric motor (e.g., brushless motor, stepper motor, etc.). Rotationvia the motor may be controlled by one or more user input means such asa button 90. In embodiments including at least one button 90, the button90 or buttons 90 may control the speed and direction of movement of thepivot arm 198.

In some embodiments, the pivot shaft 204 may project to the outside ofthe handle distal section 30. In such embodiments, the pivot shaft 204(or an overlying hub or sleeve) may be directly rotated by the user. Insome embodiments, the portion of the pivot shaft 204 projecting out ofthe handle distal section 30 may include a knob, dial, crank, etc. sothat a user may easily rotate the pivot shaft 204 by grasping androtating the knob, dial, crank, etc.

As shown in FIG. 14, the sealing member 210 is positioned in a gasketrecess 270. The gasket recess 270 may include gasket arm recesses 272.Various components may pass through the sealing member 210 as mentionedabove. As shown, a flex cable 250, connected to a printed circuit board430 a (see, for example, FIG. 96) in the electronics section 80 housedin the handle proximal section 16 may pass through the flex cableorifice 214 of the sealing member 210 and extend beyond the sealingmember 210 through the housing of the handle distal section 30 andsheath mount 160, ultimately to travel distally in the insertion sectionof the endoscope. The irrigation line 434 (see FIG. 96) and fiberopticbundle (e.g., illumination fibers 364, see FIG. 96) may pass throughtheir respective irrigation line orifice 216 and fiberoptic bundleorifice 212 and extend through the housing of the handle distal section30 similar to the flex cable 250. In some embodiments, a sealing member210 may not be included. Instead the electronics section 80 may not bepartitioned from the rest of the handle 12. In such embodiments, theenclosed printed circuit board 431 (see, e.g. FIG. 15) may be coated orencased in a protective coating or layer, such as potting. Inembodiments including a sealing member 210 a printed circuit board (see,e.g. FIG. 15) may still be encased in a protective coating or layer.Additionally or alternatively, the inner sheath mount 160 may include aflexible member 153 similar to that shown in FIG. 11B-C which forms aseal around and displaces as any pass-through components (e.g. flexcable 250, actuators/cables, illumination fibers, etc.) running throughthe inner sheath mount 160 are displaced.

Only one half of the gasket recess 270 is shown in FIG. 14. The otherhalf of the gasket recess 270 may be located on the other, not shownhalf (30 b, see FIG. 8, for example) of the handle distal section 30.When fully assembled, the sealing member 210 is captured between the twohalves of the gasket recesses 270. When fully assembled the sealingmember 210 may ensure that fluid which may be present in the handledistal section 30 may be inhibited from infiltrating into the handleproximal section 16, which contains electronics components comprisingelectronics section 80. The sealing member 210 may be made of suitablycompliant (e.g., elastomeric) material or other suitable gasket materialand may be pressed into the gasket recesses 270 to ensure a tight seal.In some embodiments, the sealing member 210 may be held in place usingan adhesive.

FIG. 15 shows another example embodiment of one half (30 a) of thehandle distal section 30. As shown, a pass-through barrier 159 and apivot control structure 100 are assembled and placed within the shownhalf (30 a) of the handle distal section 30. An enclosure 431 of aprinted circuit board which has been encased in a protective material752 is also shown in place within part 30 a of the handle distal section30. In some embodiments, a projecting portion 430 h may be a ribbon orflex cable 250 (see, e.g., FIG. 14). The printed circuit board maycommunicate with components at the distal end of the shaft 14 throughone or more ribbon cables that pass through the bulkhead or pass-throughbarrier 159. These cables may or may not need to slide somewhat back andforth through the bulkhead, to accommodate rotational movement of thesensor or camera housing at the distal end of the endoscope shaft, or toaccommodate flexion and extension of the shaft 14 if it is a flexibleshaft. Alternatively, the PCB may include an extension 430 h of the PCBitself which extends into the shaft or insertion section 14 through thepass-through barrier 159. In some specific embodiments the printedcircuit board and its extension 430 h may be similar to that shown anddescribed in relation to FIGS. 33.2 and 33.3, or FIG. 67. A sealingagent 151 is shown in place around the projecting portion 430 h. Thepass-though barrier 159 may include a peripheral gasket 163 (see, e.g.FIG. 11D) in some embodiments. The pass-though barrier 159 may becoupled to the handle distal section 30 in any number of ways, includingbut not limited to, adhesive, epoxy, glue, solvent bonding, press fit,etc.

The pivot control structure 100 of FIG. 15 is similar to that shown inFIG. 12 and FIG. 14. However, the pivot control structure 100 mayinclude arms 97 which interface with ridges 94 described above inrelation to FIG. 7C. Additionally, in this particular embodiment, thepivot arm 198 of the pivot control structure 100 does not includepull-wire attachment holes 202 (see, e.g. FIG. 14). Instead, fasteners203 or a similar structure including eyelets 201 may be attached to orprovided as part of the pivot arm 198. Pull-wires may be attached to thepivot arm through the eyelets 201 and the pivot control structure 100may be used to actuate the pull-wires, e.g. to bend a flexible shaft orinsertion section 14 or to rotate a camera assembly in an insertionsection 14. The pull-wires may pass through the flexible member 153 ofthe pass-though barrier 159 to actuate components in the insertionsection 14.

As shown in FIG. 15, the pass-through barrier 159 may be the onlybarrier separating the insertion section 14 from electronic componentshoused in the handle distal section 30 and proximal section 16. Asealing member 210 (see, e.g. FIG. 14) may not be included. In someembodiments, an electronics section 80 may not be partitioned from orfluidically isolated from the rest of the handle 12. As mentioned abovein relation to FIG. 11C, a pass-through barrier 159 may include aperipheral gasket member 163 in some embodiments to provide anadditional seal.

FIG. 16 shows an example embodiment of an outer sheath or cannula mount300. As shown in FIG. 16A and FIG. 16B, an outer sheath or cannula 318may be employed to provide additional protection to components in thedistal end of the insertion section, or to allow a user to withdraw theinsertion section of the endoscope while leaving the cannula 318 insitu, to allow later re-insertion of an insertion section of theendoscope. As shown, the cannula mount 300 may have a frustoconicalshape, with the larger diameter section proximally forming a connector(e.g. bayonet mount) for the mounting of a cannula 318 over an innersheath 312 (see, for example, FIG. 17). A cannula mount hole 302 mayextend through the cannula mount 300 to merge with a cannula channel.The cannula or outer sheath mount hole 302 may be configured to acceptand retain a cannula 318. The cannula 318 may be configured to act as asleeve over an inner sheath 312 of the insertion section.

As shown, the female bayonet mount portion 304 includes two slots 306.The slots 306 optionally may have different dimensions to ensure properorientation of the cannula 318 with respect to a mating (male) connectoron a distal portion of the handle distal section 30. In someembodiments, the slots 306 of the female bayonet mount portion 304 mayinclude a serif into which the male bayonet mount portion 308 may bespring loaded using, for example, a Belleville washer. In suchembodiments, a spring-loaded connection may help ensure the two pieces(cannula 318 and handle distal section 30) are more securely lockedtogether.

In some embodiments, an alignment feature may be included on the cannulamount 300 in order to properly orient the cannula 318 with the cannulamount 300 during assembly, and ultimately with the inner sheath 312(see, for example, FIG. 17) when installed over the inner sheath 312 ofthe insertion section. In the example embodiment in FIG. 16, an outersheath mount tab 310 may project from the inner wall of the outer sheathmount hole 302. The outer sheath mount tab 310 may extend from a distalface of the female bayonet mount portion 304, which may then be used toalign the bayonet mount 300 with a cannula 318 having a mating slotduring assembly. Alternatively, the need for such a feature may beremoved by coupling the outer sheath or cannula 318 and cannula mount300 in a suitable fixture.

FIG. 17 shows a partial cutaway view of an example embodiment of thedistal face of the handle distal section 30. An inner sheath 312 ismounted on the sheath mounting hub 252 of the inner sheath mount 160.The inner sheath 312 includes a sheath mount notch 314. The inner sheathmount notch 314 may be dimensioned to accept the sheath mounting tab 254on the sheath mounting hub 252. In such embodiments, the sheath mountingtab 254 and inner sheath mount notch 314 may ensure that the innersheath 312 is correctly oriented on the endoscope 10.

The inner sheath 312 (and/or the outer sheath or cannula 318, see FIG.16) may be formed from steel, any of a number of hardened plastics orother rigid, durable material. Alternatively, the inner sheath 312 or aportion thereof may be flexible, allowing the insertion section of theendoscope to bend as needed for insertion into a non-line-of-site targetarea. In these embodiments, a user may forgo the use of an outer sheathor cannula 318, or the cannula 318 itself may also be constructed of asimilarly flexible material.

The male bayonet mount portion 308 is also visible in the exampleembodiment shown in FIG. 17. The male bayonet mount portion 308 mayinclude two prongs 316. The prongs 316 may be sized to fit in the legsof the L-shape slots 306 of the female bayonet mount portion 304referring now also to FIG. 16. The outer sheath 318 and cannula mount300 may be coupled to the handle distal section 30 by aligning theprongs 316 with the slots 306, pressing the bayonet mount over prongs316, and then turning the bayonet mount to lock it into position. Asshown, optionally the two prongs 316 are dimensioned differently suchthat the outer sheath mount 300 may only have one possible orientationwhen coupled onto the handle distal section 30.

Still referring now to both FIGS. 16-17, an outer sheath or cannula 318may be slid over the inner sheath 312, forming a sleeve. The innerdiameter of the outer sheath 318 may be only slightly larger than theouter diameter of the inner sheath 312 to ensure a snug fit. The outersheath 318 may include an outer sheath notch 320. The outer sheath notch320 may be dimensioned to accept the outer sheath mount tab 310 when theendoscope 10 is fully assembled. In some embodiments, the outer sheath318 may be friction fit, glued or otherwise fused or attached to thewall surrounding the outer sheath mount hole 302. The outer sheath mounttab 310 may help to ensure correct orientation of the outer sheath 318when the endoscope 10 is fully assembled.

When the shaft or insertion section 14 (see FIG. 3) of the endoscope 10is inserted into a target region, the outer sheath 318 and outer sheathmount 300 may be uncoupled from the rest of the endo scope 10 asmentioned above. This may allow the outer sheath 318 to be used as acannula, remaining in situ to permit the endoscope 10 to bere-introduced into the target region.

Shown in FIG. 17A is a trocar or obturator 319 adapted for use with theouter sheath 318. During introduction of the endoscope into the surgicalfield, the trocar may be inserted into an outer sheath 318 to facilitateentry of the outer sheath 318 into the desired location, after which thetrocar can be withdrawn and the inner sheath 312 of the shaft 14 can beinserted. If the shaft 14 needs to be substantially repositioned withinthe surgical field during an operation, the endoscope shaft 14 can bewithdrawn from the patient while keeping the outer sheath 318 in place,the trocar can be introduced into the outer sheath 318, and thetrocar/outer sheath assembly can be repositioned as needed. Once in theproper location, the trocar can be withdrawn from the outer sheath 318,and the endoscope shaft with inner sheath 312 can then be re-insertedinto the outer sheath 318. In the example shown, the trocar 319 includesa solid shaft portion 321 with pointed or blunted end 323, and a baseportion 325. The base portion 325 is optionally equipped with a lockingmount that matches that of the distal handle section 30 of the endoscopehandle, so that the trocar can be secured to the outer sheath 318 whenin use. If desired, the outer sheath or cannula 318 may be used as aconduit through which other instruments may be introduced into thetarget region. The outer sheath 318 may also function as a conduitthrough which fluid may be introduced or withdrawn from the targetregion.

A camera assembly housing 330 or distal working section is shown in FIG.18, separated from a distal end of an inner sheath 312. In thisembodiment, the distal working section of an insertion section of anendoscope may be constructed separately from the inner sheath 312, andsubsequently mated to a distal end of the inner sheath 312 duringassembly. In other embodiments the inner sheath 312 may be constructedas a single piece, incorporating a distal working section. Inembodiments where the distal working section is constructed separately,the distal working section may be made from a material different fromthat of the inner sheath 312. Additionally, it may be constructed from anumber of assembled parts.

In the example embodiment in FIG. 18, the distal edge of the innersheath 312 includes an inner sheath distal notch 322. The cameraassembly housing 330 may include a nested segment 332, shaped and havingan outer diameter suitable for insertion into the distal end of innersheath 312 during assembly of the endoscope 10. The nested segment 332may include a nested segment tab 334 or other alignment feature. Thenested segment tab 334 may be dimensioned so that it may be mated to theinner sheath distal notch 322 when the endoscope 10 is assembled. Thenested segment tab 334 and inner sheath distal notch 322 may help ensurethat the camera assembly housing 330 is properly oriented and alignedwhen the endoscope 10 is assembled.

The camera assembly housing 330 may additionally include a workingsegment 336. As shown, the working segment 336 in FIG. 18 may include atop void 338 with or without a bottom void 340. The top void 338 andbottom void 340 may extend along most of the working segment 336 of thecamera assembly mount 330. A rounded tip 342 may be included at thedistal end of the working segment 336 of the camera assembly mount 330.As shown, the rounded tip 342 may optionally include an embrasuredopening 344. The edges of the embrasured opening 344 may be beveled,chamfered or rounded. In the example embodiment, the embrasured opening344 is continuous with the top void 338. In some embodiments, the topvoid 338 and bottom void 340 may be similarly embrasured.

A rounded tip 342, such as the rounded tip 342 shown in FIG. 18 mayprovide a number of benefits. A rounded tip 342 may facilitate theinsertion of the insertion section 14 into a target region of a patient.In some cases, this may eliminate the need for a trocar. In arthroscopicapplications, the contours of the rounded tip 342 allow the endoscope 10to be maneuvered into tight spaces within a joint. A rounded tip 342additionally may allow a surgeon to exert pressure atraumatically ontissues within a target region. The rounded tip 342 may also serve as aguard feature for a camera assembly 350.

As shown in FIG. 18, the interior walls of the working segment 336 ofthe camera assembly housing 330 include two camera mount pivot bearings346. In the example embodiment shown in FIG. 18, the camera pivotbearings 346 project substantially perpendicularly from the inner sidewalls of the camera assembly mount 330. The camera assembly housing 330may be made of steel, any number of hardened plastics, or any othersuitably strong, rigid material.

In the example embodiment shown in FIG. 18, the interior walls of theworking segment 336 of the camera assembly housing 330 include a numberof cable guide holes 348. In a preferred embodiment, there may only betwo cable guide holes 348. One cable guide hole 348 may be located onone side wall while another cable guide hole 348 may be located on anopposing side wall. Preferably, the cable guide holes 348 may bedisposed below the camera mount pivot bearings 346, so that the distalend of a control cable may form an angle with respect to a camera,camera mount, or camera assembly 350 (see, for example, FIG. 23) towhich it is connected. The camera assembly housing 330 may also includeone or a number of constraining features. In the example embodimentshown in FIG. 16, there are two restraining notches 349. One restrainingnotch 349 is located on one side wall and the other restraining notch349 is located on an opposing side wall. As shown in FIG. 16, therestraining notches 349 are roughly in line with the cable guide holes348. The cable guide holes 348 and restraining notches 349 will bedescribed further below.

FIG. 19 depicts an embodiment of a distal working section or cameraassembly housing 330 and inner sheath 312 which are constructed as asingle part. Referring also to FIG. 20, a cross section taken at line20-20 of the camera assembly housing 330 in FIG. 19 is shown. Inembodiments where the distal working section or camera assembly housing330 and the inner sheath 312 are constructed as a single part, they maybe made from steel. In such instances the tip shape of the inner sheath312 and camera assembly housing 330 may be created via a rollingprocess. Various voids, openings, and other features, for example thosedescribed above, may then be post machined into the part. In the exampleembodiment in FIG. 19, the camera assembly housing 330 includes only thecamera mount pivot bearings 346.

It may be advantageous to create the inner sheath 312 and the cameraassembly housing 330 as a single part. Among the advantages, the partmay be stronger. Another advantage is that the need for a nested portionis removed. Consequently, a “choke point” in cross-sectional area at thejunction of the inner sheath 312 and camera assembly housing 330 isremoved. This may provide a number of benefits. Removing such a chokepoint allows more room for various components, such as utilitycomponents within the inner sheath 312 and camera assembly housing 330.Moreover, removal of such a choke point allows for increased flow ofirrigation fluid within the inner sheath 312 and camera assembly housing330. Alternatively or additionally, the overall diameter of the innersheath 312 and camera assembly housing 330 may be decreased. The innersheath 312 and camera assembly housing 330 may also be thickened. Thishelps to strengthen the part. Since thickening will strengthen the part,it may also allow an outer sheath or cannula 318 to be made thinner. Athinner outer sheath or cannula 318 in turn may allow for a largerdiameter inner sheath 312 and camera assembly housing 330. That is,without increasing the overall diameter of an insertion section 14(comprised of an outer sheath 318, inner sheath 312 and camera assemblyhousing 330), the cross-sectional area of a conduit within the insertionsection 14 may be made larger. Thickening furthermore enables the cameramount pivot bearings 346 to have a larger bearing surface allowingpressure exerted against the bearing to be spread over a larger area.

FIG. 21 shows an assembled view of the tip of the insertion section 14(best shown in FIG. 3A). The camera assembly housing 330, cameraassembly 350, and outer sheath or cannula 318 are visible in FIG. 21. Asshown, the rounded tip 342 of the camera assembly housing 330 projectspast the distal end of the outer sheath or cannula 318. A viewing notch352 is recessed into the top of the outer sheath 318. The cameraassembly 350 may be pannable throughout the viewable range as defined bythe opening created by the combination of the embrasured opening 344 andthe viewing notch 352. In some embodiments the pannable range may beapproximately 180°. When panning, the camera assembly 350 may pivot onthe camera pivot bearings 346 (see, for example, FIG. 18). Panningactuation will be described further below.

In some embodiments, the outer sheath 318 may be rotated to an insertionposition (not shown) when the insertion section 14 (see FIG. 3) of theendoscope 10 is being inserted into the target region. In the insertionposition, the viewing notch 352 may not be aligned with the embrasuredopening 344 and top void 338. This may help protect the camera assembly350 during insertion, and in medical applications may reduce the risk ofdamage to tissue upon insertion of the insertion section 14. Afterinsertion, the outer sheath 318 may be rotated back to a position inwhich the viewing notch 352 is aligned with the embrasured opening 344and top void 338 so that the full viewable range is again available.

In some embodiments, a cap or window material may cover or be placed inthe openings defining the viewing notch 352 and embrasured opening 344to protect the camera assembly 350. In some embodiments, the distal edgeof the outer sheath 318 and the viewing notch 352 may be embrasured,rounded, beveled, etc. to help prevent damage that might result fromhaving sharp edges.

In the example embodiment, a cap or window is not used. Such anarrangement provides a number of benefits. For example, by not using acap or window at the tip of the insertion section 14, the cost of theendoscope may be reduced because no expensive scratch and wear resistantmaterials such as sapphire, specialized glass, etc. are used. Not havinga cap or window may also eliminate any undesirable reflections from thesurface of the cap or window, which could otherwise affect the clarityof any image captured by a camera. Moreover, by not using a cap orwindow, irrigation of the target area may be conducted through theconduit of the inner sheath 312 (see FIG. 15) of the endoscope 10. Thisenables the total diameter of the insertion section 14 to be kept smallwhile retaining irrigation capabilities. Furthermore, irrigation flowwithin the inner sheath 312 may help to clear/clean any debris ormaterial away from the camera assembly 350 and any associated lens orlenses. In one example, a user may be able to effectively irrigate thecamera assembly 350 by panning the camera assembly 350 during irrigationso that the irrigation flow washes over a lens assembly 354 (see, forexample, FIG. 24) of the camera assembly 350 and carries away the debrisor unwanted material. As an added benefit, the irrigation flow may alsohelp to cool an image sensor 380 (see, for example, FIG. 63) associatedwith the camera assembly 350.

As shown, the embrasured opening 344 and viewing notch 352 may bedimensioned in order to protect the camera assembly 350 without the needfor a cap or window. In the example embodiment in FIG. 21, theembrasured opening 344 and viewing notch 352 partially envelop thecamera assembly 350, which is recessed from the outer surfaces formed bythe embrasured opening 344 and viewing notch 352. Thus the embrasuredopening 344 and viewing notch 352 define the edges of a guard for thecamera assembly 350. The partial envelopment helps to protect movablecomponents of the camera assembly 350 and any associated components(e.g. control, electric, information cables, etc.) from contact withexternal objects either during insertion of the insertion section intothe target region, or during use of the instrument once in the targetregion. The embrasured opening 344 and viewing notch 352 provide thecamera assembly 350 an unrestricted view while exposing only a smallpart of the camera assembly 350 to possible damage from objects externalto the insertion section (such as, e.g., a medical instrument such as ashaver). This helps to ensure that the camera assembly 350 is notdamaged during insertion or during a procedure.

As the camera assembly 350 rotates, the distance between the cameraassembly 350 and the outer sheath 318 will change. As a consequence, theamount of the outer sheath 318 which falls into the field view of thecamera assembly 350 will also change. The greater the distance from thecamera assembly 350 to the inner sheath 318, the greater the amount ofthe outer sheath 318 which will be in the field of view of the cameraassembly 350. Thus, an optimized amount of protection while stillaffording the camera assembly 350 and unrestricted view may be achievedby varying the width of a viewing notch 352.

FIG. 22 depicts an alternate assembled view of the tip of an insertionsection 14 (best shown in FIG. 3A) in which the viewing notch 352 has avarying width. The width of the viewing notch 352 varies such that theviewing notch 352 is just outside of the field of view of the cameraassembly 350 in any angular orientation of the camera assembly 350. Thisallows for a greater degree of envelopment of a camera assembly 350 byan outer sheath 318.

FIG. 23 depicts another alternate embodiment of a tip of an insertionsection 14 (best shown in FIG. 3A) in which a number of openings 353separated by bars 351 are included in place of a viewing notch 352 likethat shown in FIG. 20. Such an arrangement may provide additionalprotection to a camera assembly 350. To minimize the amount that thebars 351 obscure the field of view of the camera assembly 350, the bars351 may be made of a transparent material. In other embodiments the bars351 may be made of an opaque material, for example, the same material asthe outer sheath 318.

Alternatively a cover member (not shown) which partially covers aviewing notch 352 (see FIG. 22) or one or more openings 353 (see FIG.23) may be mounted to the distal tip of a shaft or an insertion section14 (see, for example, FIG. 1) Such a cover member may for example be acage which allows a substantially clear field of view for the cameraassembly 350 while providing additional protection for the cameraassembly 350. In some embodiments, the cover member may include anoptically clear partial covering.

In another embodiment, the camera assembly may be mounted at the distalend of an endoscope shaft without a protective tip structure 342.Although a tip structure 342 may provide some protection to a cameraassembly, it may also inhibit a full field of view of the camera in allpositions within its range of motion. An example of an alternativearrangement is shown in FIG. 23.1. In this example, the sensor or camerahousing 500 itself is constructed to provide adequate protection to anenclosed camera assembly (e.g., lens and sensor assembly). For example,the camera housing 500 may be at least partially constructed of steel orsimilarly strong material; at least an outer shell of the housing can beso constructed to withstand physical abuse when the insertion end of theendoscope is introduced or repositioned. The exposed portion of thehousing 500 preferably has an outer spherical, spheroid (oblate,prolate, etc.) or dome shape—or an otherwise rounded shape providingrounded edges to help prevent damage to tissues as the endoscope shaftis inserted or moved within the operative field. Placing the cameraassembly in a reinforced and at least partially rounded housing 500 atthe distal end or tip 550 of the endoscope shaft 14 provides anunobstructed view of a greater portion of the surgical field, withoutplacing the camera assembly or nearby tissues at risk of damage. In thisexample, the sensor or camera housing 500 can be rotated using pullwires 502, cables or bands about an axis 504 so that an optical axis ofthe camera assembly (lens and sensor assembly) can be aimed from lessthan zero degrees to more than ninety degrees with respect to the longaxis of the distal end 550 of the endoscope shaft 14. If the sensor orcamera assembly is arranged to have a wide field of view, then the rangeof motion of the camera housing can be arranged to provide an opticalaxis range of motion of between about 35 degrees and about 115 degreeswith respect to the long axis of the endoscope shaft at its distal orinsertion end. In this arrangement, the operator can still view theoperative field directly opposite the distal end of the endoscope shaft,yet be able to view a region of the surgical field behind the tip of theendoscope. This arrangement may also allow the operator to irrigate thesurface of the camera assembly to remove any accumulated surface debrisby rotating it to a position equal to or greater than 90 degrees.

A camera assembly 350 is shown in isolation in FIG. 24. This arrangementis more suited to the insertion section or shaft shown in FIG. 23,because of the physical protection offered by the rounded tip 342 of theworking end of the distal endoscope shaft shown in FIGS. 18-23. Asshown, a ribbon or flex cable 250 is coupled into the camera assembly350 and may provide power and data communication paths to and from thecamera assembly 350. The camera assembly 350 may be any suitablestructure configured to support the camera of the endoscope 10. Inembodiments where the camera assembly 350 may be panned, the cameraassembly 350 may include pivot actuator attachment features.

As shown, the camera assembly 350 may include a lens assembly 354. Asshown, the lens assembly 354 may be held in place between a camerahousing top 356 and a camera housing bottom 358. When assembled, thecamera housing top 356 and camera housing bottom 358 may be coupledtogether by any suitable means, such as, but not limited to glue,adhesive, ultrasonic welds, press fit of cooperating features, etc. Inthe example embodiment in FIG. 24, the lens assembly 354 projectsthrough a lens opening 360 in the camera housing top 356 such that itmay have a clear view of the target anatomical area. In someembodiments, at least a portion of the lens assembly 354 may be proud ofthe camera housing top 356.

The camera housing top 356 may include a number of other voids. In theexemplary embodiment shown in FIG. 24, the camera housing top 356includes two elongate light projection voids 362 disposed on the rightand left (relative to FIG. 24) flanks of the lens opening 360, the voids362 being designed to accommodate terminal elements of optical fibers(or optionally other light sources such as LEDs) to project light onto atarget area coinciding with the direction at which a camera lens or lensassembly 354 may be aimed. In the example shown, the right elongate void362 is trapezoidal in shape while the left elongate void 362 is rhomboidin shape. In alternative embodiments, the shape of the voids 362 maydiffer, for example, both may be ovoid. In alternative embodiments,there may be additional voids 362. For example, in some embodiments,there may be three voids 362 arranged in a triangular configurationaround the lens opening 360. In some embodiments there may be four voids362 arranged in a rectangular, square, circular, or ovoid configurationaround the lens opening 360.

One or more illumination sources for the endoscope 10 may be included atleast partially within the endoscope 10. The illumination source orsources may illuminate the field of view of the camera of the cameraassembly 350 regardless of its panned position. In some embodiments, theillumination source may be in the camera assembly 350. In the exampleembodiment in FIG. 24, the illumination source is a number of opticalfibers (e.g. fiberoptic fibers) 364 which may transmit light from alighting element (not shown) external to the endoscope 10. The opticalfibers 364 may be routed and coupled into the voids 362 in the camerahousing top 356. In the example embodiment, 28 optical fibers 364 arerouted into the voids 362 of the camera housing top 356. The number ofoptical fibers 364 may differ in alternate embodiments. The lightemitting ends of the optical fibers 364 may be roughly flush with thetop face of the camera housing top 356. In some embodiments, otherillumination sources, for example LEDs, may be used. The optical fibers364 or other illumination source may be configured to supply any desiredcolor or intensity of light at a pre-determined light projection angle.

As shown in the example embodiment in FIG. 24, the camera assembly 350may include pivot pins 366. The pivot pins 366 may be pivotally coupledinto the pivot pin bearings 346 in the camera assembly housing 330 (seeFIG. 18). The pivot pins 366 may project substantially perpendicularlyfrom the long axis of the insertion section. The pivot pins 366 mayallow the camera assembly 350 and optical fibers 364 (or otherillumination source) to pivot in tandem with one another.

The camera assembly 350 may also include a pivot actuator attachmentfeature as mentioned above. In the example embodiment in FIG. 24, thecamera assembly 350 includes a top cable attachment feature or anchorpoint 372 and a bottom cable attachment feature or anchor point 374. Thetop cable attachment feature 372 and bottom cable attachment feature 374will be further discussed below.

As mentioned above, the endoscope 10 may also include a pivot actuatoror actuators. A pivot actuator may be an elongate member used to pull onor push the camera assembly 350 via a pivot attachment feature. In theillustrated examples, the pivot actuators are mostly pull cables orwires, but these examples should not be construed as strictly limitingpivot actuators to a cable-like structure. The elongate member may beflexible or substantially rigid. The elongate member may be round (as inthe example of a cable), flat, or may have any other shape or crosssection. In some embodiments, the pivot actuator may be a belt routedaround a cooperating attachment feature frictional engaged or otherwisemeshed with features on the inner circumference of the belt. In apreferred embodiment, the pivot actuator may be used to only supply apulling force. Such an arrangement allows for a smaller diameterinsertion section 14 (see FIG. 3A) because the pivot actuator does nothave to be sufficiently thick or cross-sectionally strengthened, orconfined within a supporting track to prevent substantial lateraldisplacement within the insertion section 14 in response to a pushingforce against the pivot actuator. A pull-wire or pull-cable arrangementalso allows a greater range of materials to be used in constructing thepivot actuator because the material only needs to have tensile strength,rather than compressive stiffness.

As shown in FIG. 25, panning cables may be attached to the cameraassembly 350 above and below the pivot pins 366. In the exampleembodiment, the panning cables are shown as relatively slack for ease ofillustration. In operation one or more panning cables on one side of thepivot pins 366 would be under tension, while one or more panning cableson the other side of the pivot pins 366 would be slack. As detailedabove and referring now also to FIG. 14, the panning cables may beattached proximally to the cable attachment holes 202 of the pivotcontrol structure 100 (see FIG. 14). In some embodiments, two panningcables may be attached to each cable attachment hole 202. The panningcables may extend from the cable attachment holes 202 in the pivot arm198 and be routed through one or more orifices 178 in the proximalsection 161 b of the inner sheath mount 160 (see FIG. 11A). The panningcables may then extend through the utility hole 168 alongside the flexcable 250. Since the cable attachment holes 202 are located on oppositesides of the pivot point of the pivot arm 198, pivoting the pivotcontrol structure 100 may cause the panning cables attached to one ofthe cable attachment holes 202 to slacken and panning cables attached tothe other to become taut. By attaching the panning cables associatedwith one cable attachment hole 202 to the camera assembly 350 on oneside of the pivot pins 366 and attaching the panning cables associatedwith the other cable attachment hole 202 to the opposite side of thepivot pins 366, the pivot control structure 100 may be used toselectively rotate the camera assembly 350. In some embodiments, pushingthe pivot control structure 100 forward may pan the camera assembly 350forward while pulling the pivot control structure 100 aft may pan thecamera assembly 350 backward. In some embodiments, when assembled, allof the panning cables may be under tension.

In a preferred embodiment, only a single panning cable may be attachedto each cable attachment hole 202 on the pivot control structure 100pivot arm 198 (see FIG. 14). In such embodiments, there may be a toppanning cable 368 and a bottom panning cable 370. The top panning cable368 and bottom panning cable 370 may extend as described above to thecamera assembly 350. The top panning cable 368 may wrap around a topcable attachment feature 372 on the camera assembly 350 and return backto the same cable attachment hole 202 on the pivot arm 198 from which itoriginates. The bottom panning cable 370 may wrap around a bottom cableattachment feature 374 on the camera assembly 350 and return back to thesame cable attachment hole 202 from which it originates. Alternatively,the panning cable may be looped through attachment hole 202, with bothends of the cable terminating on the cable attachment feature distally.

In the example embodiment, the top cable attachment feature 372 (bestshown in FIG. 24) includes two holes in the camera housing top 356. Thetop cable attachment feature 372 additionally includes a recess thatconnects the two holes. The top panning cable 368 may enter one of theholes, follow the recess, and exit the other of the two holes to returnto the cable attachment hole 202 (see FIG. 14) in the handle. The bottomcable attachment feature 374 (best shown in FIG. 24) includes twoattachment points or hooks which project off opposite sides of thecamera housing bottom 358. The bottom cable attachment feature 374 is onthe opposite side of the pivot pins 366 than the top cable attachmentfeature 372. The bottom panning cable 370 may be wrapped around oneattachment point or hook of the bottom cable attachment feature 374,strung over to the second attachment point or hook of the bottom cableattachment feature 374 and from there return to its cable attachmenthole 202 on the pivot arm 198 of the handle. In alternate embodiments,the top cable attachment feature 372 and/or bottom cable attachmentfeature 374 may comprise, for example, eyelets, prongs, pegs, etc.

The top panning cable 368 and bottom panning cable 370 may be made fromany suitable cable or wire-like material, either metallic or syntheticpolymer, either braided or monofilament. The top panning cable 368 andbottom panning cable 370 may, for example, be metal or plastic strips orbands that are laterally flexible. In a preferred embodiment, the toppanning cable 368 and bottom panning cable 370 are made from a materialwhich is resistant to stretching under tension. Wrapping a singlepanning cable from each cable attachment hole 202 on the pivot arm 198(see FIG. 14) around a pivot actuator attachment feature on the cameraassembly 350 may be desirable because it ensures that the side of thepanning cable running to the camera assembly 350 is under the sametension as the side of the panning cable returning from the cameraassembly 350; any stretching of some portion of the cable over time oruse will have an equal effect on both halves of the cable.

In a preferred embodiment, the top panning cable 368 may be run throughone of the cable guide holes 348 on each interior wall of the cameraassembly mount 330. As shown in FIG. 25, the top panning cable 368 isthreaded through one of the cable guide holes 348 and continuesextending toward the camera assembly 350 along the exterior of thecamera assembly housing 330. In some embodiments, there may be adepression or trough recessed into the exterior of the camera assemblyhousing 330 along the path taken by the top panning cable 368. In suchembodiments, the depression or trough may serve as a guide. Thedepression or trough may also help to ensure that the top panning cable368 is roughly flush to exterior surface of the camera assembly housing330. This may help to ensure that the outer sheath 318 (see FIG. 21)does not impinge on the top panning cable 368 to impair its movementduring the use of a fully assembled endoscope 10.

As shown in FIG. 25, the top panning cable 368 is strung through theconstraining notch 349 as it re-enters the interior of the cameraassembly housing 330. The top panning cable 368 then runs to the topcable attachment feature 372 as describe above. On return to the cableattachment hole 202 (see FIG. 14), the top panning cable 368 runs fromthe top cable attachment feature 372 to the constraining notch 349 onthe opposite wall (see FIG. 18) of the camera assembly housing 330. Thetop panning cable 368 then runs along the exterior surface of the frontwall of the camera assembly housing 330 and optionally along adepression or trough in the wall. The top panning cable 368 thenre-enters the interior volume of the camera assembly housing 330 andtravels back to the cable attachment hole 202 in the handle as describedpreviously.

A terminal segment of a pivot actuator (such as a wire or cable)proximal to its connection to a pivoting assembly at the distal end ofthe insertion section may be constrained at a fulcrum or support pointto re-direct the actuator so as to form an angle with respect to thelong axis of the insertion section or shaft. For example, by running thetop panning cable 368 through the cable guide holes 348 and theconstraining or re-directing notches 349, and then angling it up to thetop cable attachment feature 372 on the other side of pivot pin 366, anincreased pivotal range for the pivoting camera assembly 350 may beachieved. Thus an image sensor having a pre-determined or fixed angularfield of view may be rotated to allow for a rotatable field of view, sothat the viewable area can be increased to a range of up to 180 degrees.In other embodiments, an image sensor may be rotated so as to achieve aviewable area that exceeds 180 degrees. As shown in FIG. 25, having thecable routed as described places the cable at a more acute angle ofincidence to its attachment point 372, and thus permits a greater degreeof back-rotation of the camera assembly 350.

In some embodiments, and referring now also to FIG. 26, the cameraassembly 350 may be capable of rotating a full 180 degrees or more,because of the presence of two sets of cable guide holes 348: a lowerset of guide holes 348 to control the camera housing top section, and anupper set of guide holes 348 to control the camera housing bottomsection. The degree to which the camera assembly 350 can be rotated is afunction of the angle that the terminal portion of the panning cablemakes with respect to the proximal portion of the panning cable or thelongitudinal axis of insertion section (or endoscope shaft) 14 (see FIG.1). The greater the angle the terminal portion of the panning cablemakes as it re-enters the exterior of the camera assembly housing 330 inrelation to the longitudinal axis of the insertion section 14, thegreater the range of motion it can induce in the camera assembly 350. Ina preferred embodiment, the re-entry surface or re-directing guide ofthe camera assembly housing 330 is positioned to provide for an angle ofthe terminal portion of the panning cable to be within a range of about30-90 degrees with respect to the long axis of insertion section 14. Inother embodiments, the rotational range of motion of the camera assembly350 may be improved while limiting the frictional resistance of thepanning cable by positioning the cable re-entry surface or guide toachieve an angle of the terminal portion of the panning cable to bewithin a range of about 45-80 degrees. Such an embodiment, as describedabove, only requires a pulling force on either of a pair ofcomplementary cables 368, 370 one angled up at a distal or terminallocation in insertion section 14 to attach to the top cable attachmentfeature 372, and one angled down at a distal or terminal location ininsertion section 14 to a corresponding bottom cable attachment feature374. With this arrangement, neither actuating cable is required to movelaterally or transversely within most of the length of insertion section14, which allows the internal space within insertion section 14 to benarrower, helping to minimize its overall diameter.

In some embodiments, a constraining or re-directing notch 349 may not beused. Some embodiments may use a different type of constraint orre-directing element incorporated into a wall at the distal end of theinsertion section. In some embodiments, a pulley or an eyelet may beused as a constraint. A pin, peg, post, etc. may also be used as aconstraint or re-directing element. In some embodiments, a curved fingeror prong may be formed in the side walls of the camera assembly housing330. The curved finger may extend into the interior volume of the cameraassembly housing 330 such that there is a space between the interiorwall of the camera assembly housing 330 and the curved finger. The toppanning cable 368 may be run through this space so that it isconstrained by the curved finger. In most embodiments, it may bedesirable that the point of contact between the constraint and the cablehas a smoothness or radius of curvature sufficient to minimize thepotential for frictional damage to the panning cable during operation ofthe endoscope. In some cases, the constraint may be coated with amaterial having a low coefficient of friction such as Teflon.

In some embodiments, the bottom panning cable 370 instead of the toppanning cable 368 may be constrained similarly to the precedingdescription to enable a greater pivotal range of the camera assembly 350in one direction of rotation over another. As shown in FIG. 26, in someembodiments, both the bottom panning cable 370 and top panning cable 368may be constrained or redirected, allowing for even greater pivotalranges.

In FIG. 26, the outer sheath 318, camera assembly housing 330, andcamera assembly 350 are shown. There are two sets of cable guide holes348. One set is above the longitudinal axis of the camera assemblyhousing 330 and the other is below the longitudinal axis of the cameraassembly housing 330. There are also two constraining notches 349. Oneof the constraining notches 349 is located above the longitudinal axisof the camera assembly housing 330 and the other is located below thelongitudinal axis of the camera assembly housing 330.

An improved mechanical advantage of the panning cables may be obtainedby positioning the re-directing element (e.g. notch) on one side of(e.g., below) the pivoting axis of the camera assembly 350, whileattaching the terminal end of the panning cable to a point on the cameraassembly 350 located on the opposing side of (e.g. above) the pivotingaxis of the camera assembly 350.

As shown, the top panning cable 368 is run through one of the cableguide holes 348 below the longitudinal axis, and re-enters the cameraassembly housing 330 at the constraining notch 349 below thelongitudinal axis. The top panning cable 368 then redirects up to thetop cable attachment feature 372 on the camera assembly 350. In FIG. 26,the bottom panning cable 370 is run through a cable guide hole 348 abovethe longitudinal axis of the camera assembly housing 330. The bottompanning cable 370 then re-enters the camera assembly housing 330 throughthe constraining notch 349 above the longitudinal axis of the cameraassembly housing 330. The bottom panning cable 370 then redirects downto the bottom cable attachment feature 374. The top panning cable 368and bottom panning cable 370 may wrap around a portion of the cameraassembly 350 depending on where the camera assembly 350 has been pivotedto. In FIG. 26 the bottom panning cable 370 is shown wrapping around aportion of the camera assembly 350.

Some embodiments may make use of a belt 384 as a pivot actuator. Anembodiment which includes a belt 384 as a pivot actuator is shown inFIG. 27. As shown, the belt 384 wraps around one of the pivot pins 366of the camera assembly 350. In some embodiments, the pivot pins 366 maybe elongated such that a portion of at least one of the pivot pins 366extends from the pivot bearings 346. In such embodiments, the belt 384may be wrapped around this portion of the pivot pins 366 as shown inFIG. 27. In some embodiments, the shape of the camera assembly 350 maydiffer such that the belt 384 may wrap around the camera assembly 350.For example, the camera assembly 350 may be a substantially cylindricalshape. The substantially cylindrical shape of the camera assembly 350may be coaxial with the pivot pins 366. In such embodiments, the belt384 may be wrapped around the circumference of camera assembly 350.

In some embodiments, the surface over which a belt 384 is wrapped may berecessed (e.g., V-shaped) in relation to the surfaces which flank it.This may help to keep the belt 384 in place during operation. In otherembodiments, any other type of guide may be used. For example, thesurface over which a belt 384 is wrapped may be flanked by two wallswhich keep the belt 384 in place during operation.

A belt 384 may be made of a high friction material so that the belt 384does not slip over the surface which it wraps around as the belt 384 isdriven. In some embodiments, the belt 384 may have a coarse surface, ormay be toothed to aid in its ability to grip or positively engage acamera assembly pivot pin 366 (which may be geared). Use of a belt 384may allow for a wide range of pivoting of the camera assembly 350without the need for a pull-cable pivot actuator to be redirectedlaterally within the insertion section 14 to achieve an equivalent rangeof motion of the camera assembly 350. This allows the insertion section14 to be made with a smaller diameter.

In embodiments using a belt 384, the belt 384 may be configured to bedriven by displacement of the pivot control structure 100 (see FIG. 14).In some embodiments, the opposite end of the belt 384 from that whichwraps around the camera assembly 350 or pivot pins 366 may wrap aroundthe pivot shaft 204 of the pivot control structure 100. In suchembodiments, rotation of the pivot shaft 204 may drive the belt 384. Theportion of the pivot shaft 204 which the belt 384 wraps around may havea relatively large diameter. This may be desirable so that only a smallpivotal displacement of the pivot shaft 204 is needed to drive the belt384 a relatively large amount. In embodiments where the belt 384includes teeth, the teeth of the belt 384 may interdigitate with a gearlocated on the pivot shaft 204 of the pivot control structure 100. Insuch embodiments, rotation of the pivot shaft 204 and gear on the pivotshaft 204 may drive the belt 384. As the belt 384 is driven, themovement of the belt 384 will exert a driving force on the cameraassembly 350 causing the camera assembly 350 to pivot.

In other embodiments, the pivot actuator may be the rack of a rack andpinion arrangement. In such embodiments, the pivot pins 366 of thecamera assembly 350 may include a toothed portion. The toothed portionof the pivot pins 366 may be the pinion gear that interdigitates withthe rack of the pivot actuator. As the rack displaces longitudinallywithin the insertion section 14, this motion is translated into rotationof the camera assembly 350 via the toothed, pinion portion of the pivotpins 366. While such an embodiment does not solely rely on a pullingforce to rotate the camera assembly 350, the pivot actuator still doesnot require lateral displacement of the actuator within the insertionsection 14. In some specific embodiments, a push-pull rack-type actuatormay nevertheless require features (e.g., rigidity, thickness) or mayotherwise be constrained within a track to prevent lateral orside-to-side flexion during the application of a compressive force onthe rack

In yet another arrangement using one or more panning cables, a similarpivotal range may be achieved without requiring any routing of a panningcable through various features included in a camera assembly mount 330.This may be desirable because it may allow the diameter of an insertionsection 14 (see FIG. 1) to be made smaller. Additionally, a cameraassembly mount 330 for such an embodiment would not require anyfenestrations (e.g. the cable guide holes 348 of FIG. 18) orre-directing elements/constraints (e.g. the constraining notch 349 ofFIG. 18) thus simplifying manufacture of a camera assembly mount. Suchan embodiment may for example use the camera assembly mount 330 andinner sheath 312 shown in the example embodiment in FIG. 19.

In such an embodiment, a camera assembly 350 may include one or morespooling features or surfaces 1400. The spooling feature is configuredto at least partially wind the terminal portion of a panning cablearound the housing of the camera assembly 350. A connection orattachment point for the terminal end of the panning cable may besituated on the camera assembly housing distal to the spooling feature.The spooling feature preferably has a curved, somewhat recessed surface,which may partially or completely wrap around a portion of the cameraassembly housing. Thus, in various embodiments, a panning cable may windaround the housing only partially, or in one or more complete loopsaround the housing. A longer spooling feature provides for a moreextensive range of rotation of the camera assembly. During actuation, anassociated panning cable may be wound or unwound from the spoolingfeature 1400. Spooling feature 1400 may increase the pivotal range of acamera assembly 350. Spooling feature 1400 may allow a more consistenttorque to be applied to a camera assembly 350 during rotation. Spoolingfeature 1400 may be constructed to create a moment arm of desired orvarying length. Additionally, positioning the spooling feature 1400radially apart from the axis of rotation of the camera assembly may helpa panning cable to generate rotational torque more efficiently.

The progression of FIGS. 28-32 conceptually illustrate a camera assembly350 including a spooling feature 1400 in a number of rotationalpositions. As shown, the spooling feature 1400 may include an arcuateportion and a straight portion. The arcuate portion is shaped such ithas a radius of curvature which extends from the pivot axis of thecamera assembly 350. The straight portion of the spooling feature 1400is angled such that is serves as a torque increasing feature.Additionally, the straight portion of the spooling feature 1400 allowsthe camera housing 355 to be made with more material (which wouldotherwise need to be removed to continue the arcuate section) and thusincreases the structural integrity of the camera housing 355. This maybe particularly important in embodiments where the camera assembly 350is designed to fit in a very small space and thus must be made with avery small form factor.

As shown in FIG. 28 the top panning cable 368 may be wound around thespooling feature 1400. A pulling force exerted by the top panning cable368 would create a torque about the pivot axis of the camera assembly350 causing the camera assembly 350 to rotate in a clockwise direction.Additionally, the straight portion of the spooling feature 1400 createsa longer moment arm thus increasing the torque generated for a givenamount of pulling force.

As the camera assembly 350 rotates to the position shown in FIG. 29, thetop panning cable 368 begins to unwind from the spooling feature 1400.As force continues to be applied and the camera assembly continues torotate, the top panning cable 368 will continue to unwind from thespooling feature as shown in FIG. 30. When sufficiently unwound, thepoint at which the top panning cable 368 leaves the spooling feature1400 will be located on the arcuate section of the spooling feature 1400(as shown in both FIG. 29 and FIG. 30). In an embodiment, all points onthe arcuate section of the spooling feature 1400 may be located an equaldistance from the pivot axis.

In an exemplary embodiment, as a pulling force continues to be exertedby the top panning cable 368, the camera assembly 350 will continue torotate until the top panning cable 368 no longer contacts the surface ofthe spooling feature 1400 as shown in FIG. 31. The camera assembly 350may then continue to rotate until the pulling force of the top panningcable 368 approaches coincidence with the axis of rotation of the cameraassembly 350. This position is depicted in FIG. 32. As would beunderstood by one skilled in the art, a panning cable 368 may be woundaround a spooling feature 1400 one or more times to increase the amountof rotation which may be created using the panning cable 368. The degreeto which a panning cable 368 winds around a contact surface on thecamera assembly 350 allows for a range of rotation of the cameraassembly 350 that exceeds 90 degrees. The degree of rotation of thecamera assembly 350 would then be limited only by the amount of slackand the flexibility of the attached electronic flex cable and/or theoptical fiber bundle.

In an embodiment, the panning cable and spooling surface are arranged topermit the camera assembly 350 to rotate to a position between about 90degrees to about 120 degrees of the long axis of the distal endoscopeshaft, orienting the lens surface of the camera assembly at leastpartially in the direction of the proximal end of the endoscope shaft.In this position, any debris or other contamination of the lens surfacemay be washed away by irrigation fluid traveling distally in theendoscope shaft.

To rotate the camera assembly 350 from its position in FIG. 32 to theposition shown in FIG. 30, a pulling force may be exerted via the bottompanning cable 370. In some embodiments, the bottom panning cable 370 mayalso be associated with a spooling feature. For example, the corners oredges of the camera assembly 350 around which the bottom panning cable370 may wrap may be rounded.

FIG. 33-34 depicts a top perspective view of a specific exampleembodiment of a camera assembly 350 which includes a spooling feature1400. The camera assembly 350 includes a lens assembly 354. The lensassembly 354 is disposed inside of a camera housing 355. The spoolingfeature 1400 may be recessed into a side of the camera housing 355 asshown. The spooling feature 1400 in the example embodiment includes anarcuate portion and a straight portion. The arcuate portion of thespooling feature 1400 is shaped such it has a radius of curvature whichextends from the center of the pivot pins 366 or pivot axis.

As best shown in FIG. 33, the wall into which the spooling feature 1400is recessed may include a first void 1402. The camera housing 355 mayalso include a second void 1404. The second void 1404 may pass throughthe top face of the camera housing 355 to the bottom face of the camerahousing 355.

As shown, only a single panning cable 1406 may be used. The panningcable 1406 may extend through both the first void 1402 and the secondvoid 1404 in the camera housing 355. One end of the panning cable 1406may be attached to a cable attachment hole 202 on the pivot arm 198 (seeFIG. 14). The other end of the panning cable 1406 may be attached to theother cable attachment hole 202 on the pivot arm 198. In someembodiments, the panning cable 1406 may be fixedly attached to thecamera housing 355 at one or more points. For example, an adhesive ofglue may be placed into one of the voids 1402 or 1404. This may ensurethat the panning cable 1406 does not slip or move over the surface ofthe camera housing 355 during actuation. Additionally, in someembodiments, the panning cable 1406 may be knotted in one or morelocation. For example, the panning cable 1406 may be fed through one ofthe voids 1402 or 1404, knotted, and then fed through the other of thevoids 1402 or 1404. Preferably, the width of the knot may besufficiently wide so as to not fit through either of the voids 1402 or1404. Such a knot may again help to keep the panning cable 1406 fromslipping or moving over the surface of the camera housing 355 duringactuation.

As would be appreciated by one skilled in the art, the embodiment shownin FIG. 33-34 may easily be modified to use two panning cables. Onepanning cable may terminate and be fixedly attached to the camerahousing 355 in or at the location of the first void 1402. A secondpanning cable may terminate and be fixedly attached to the camerahousing 355 in or at the location of the second void 1404.

In an alternative example, FIG. 23.2 shows how a pull wire 502 operatedby the pivot control structure 100 may be wrapped around and/or attachedto a rounded or dome-shaped sensor or camera housing 500 at the distalend of the endoscope shaft 14. The inner sheath 312 has been removed forclarity. In this example, camera housing 500 includes a nearlycircumferential slot 501 offset to one side of the housing 500 so as notto interfere with the lens/camera assembly contained within the housing500 (which is preferably positioned at about the center of two assembledhalves of the housing). The pull wire 502 is retained within slot 501,and may be secured to the housing 500 at recess 503. A knot placed inthe pull wire 502 may be embedded in recess 503 to act as an attachmentpoint that causes the housing 500 to rotate when the pull wire 502 ismoved back and forth along the endoscope shaft. Optionally, a smallamount of adhesive may be used to provide added attachment securityduring assembly of the endoscope. In a preferred embodiment, the pullwire 502 comprises a Kevlar thread, which provides substantiallongitudinal strength and resistance to stretching. Other wire types mayinclude steel (braided or single-strand), nylon, or other materials ofsuitable strength and resistance to stretching.

The rounded sensor housing 500 shown in FIGS. 23.1 and 23.2 can enclosea more simply constructed lens 510 and image sensor 512, and the sourceof light for illumination of the operative field can be located near thesensor/camera housing 500 without having to be mounted to the housingitself. FIG. 23.3 and FIG. 23.4 show how a rounded or dome-shapedsensor/camera housing 500 can be constructed from two sections 500 a and500 b. Each of these sections can be molded or machined to have internalcutouts for placement of the distal end of a PCB extension 514 or flexcable, its associated sensor 512 (e.g. CMOS or CCD) and a suitable lens510. The two sections 500 a and 500 b can be joined over thesecomponents by a number of methods. In the example shown, one or morepins 500 c of section 500 b can be mated with a correspondingarrangement of matching recesses 500 d of section 500 a. As shown inFIG. 23.5, a pivot shaft 505 on the outer side of each section can beinserted into corresponding holes, bearings or bushings 507 of thedistal end of the inner sheath 312 of the endoscope shaft, which may beresiliently flexible to allow for assembly. An assembled housing 500 canbe pressed or snap-fit into place within the holes 507, which may helpto keep the two sections 500 a and 500 b joined together. Optionally, anadhesive may also be used to securely join the pins 500 c to theircorresponding recesses 500 d. Although the illustrated sensor/camerahousing 500 does not include a light source, this is an option; asuitably sized LED or group of LED's can be included around theperiphery of the lens, or the terminus of a fiberoptic cable can beinstalled in a similar arrangement, as discussed below.

In an exemplary arrangement, one or more LED's 508 can be positionedalong an open portion 506 of the inner sheath 312 of endoscope shaft 14.FIG. 33.1 shows a sensor 512 and lens 510 assembly within sensor housing500 (half of the housing having been removed for clarity). Both the lens510 and sensor 512 (e.g. a CMOS or CCD sensor) are suitably sealed toprevent liquid from entering between them. The sensor 512 may beconnected to a ribbon or flex cable running through the endoscope shaftto the PCB in the endoscope handle. Similarly, the light source/LED'smay be connected to the ribbon or flex cable to receive electricalpower, or may be connected to a separate ribbon or flex cable adjacentto the sensor communications cable. In an alternative example, the mainPCB in the endoscope handle can be manufactured with an elongateextension arranged to extend through the endoscope shaft to one or morecomponents at the distal end of the shaft. The PCB may be constructed tohave a flexible component sandwiched together with a rigid component.The flexible component may emerge from the main PCB to form a PCBextension for the endoscope shaft. The rigid component may similarlyemerge from the main PCB to form a PCB extension for the endoscopeshaft. Either or both of these extensions may alternatively be combinedwith a ribbon or flex cable coming from the main PCB to provide power orcommunications to components at the distal end of the endoscope shaft.For example, sensor 512 can be mounted to the distal end of a flexiblePCB extension 514 from the main PCB in the endoscope handle 12. Thesensor PCB extension 514 is flexible and has sufficient slack to permitrotation of the sensor 512 and lens 510 as the sensor housing 500 isrotated. Also, the light source in this example comprises one or moreLED's 508 mounted to either the sensor PCB extension, or preferablymounted to a separate light source PCB extension 516. Because of thepower requirements of the light source, mounting the power supply wireson a separate flex cable or PCB extension 516 may increase thereliability of the endoscope. Also, if the endoscope shaft 14 is rigid(e.g. as would be the case for most arthroscopes), the light sourcepower wires can be mounted to a rigid PCB extension, further enhancingthe overall robustness of the endoscope. In the example shown in FIG.33.1, a flexible sensor PCB extension 514 has been folded over at itsbase and placed against a rigid light source PCB extension 516, bothextensions merging into the main PCB within the handle 12 of theendoscope (see below).

The form factor for the printed circuit board (PCB) for the embodimentshown in FIGS. 23.1 and 33.1 is shown in FIG. 33.2. Note that the formfactor shown in FIGS. 33.2 and 33.3 may also be used to represent how aribbon or flex cable can be folded over to run adjacent a companionribbon or flex cable, or adjacent a companion PCB extension through thebulkhead and along the endoscope shaft to connected components at thedistal end of the shaft. In one example, the rigid main PCB 518 (onwhich a number of electronic processing components are mounted)comprises a composite of both rigid and flexible components sandwichedtogether, the main PCB 518 being located within the endoscope handle. Aflexible PCB extension portion 514 emerges from the composite main PCB518 at an angle to the direction of a rigid extension portion 516, sothat a proximal leg 514 a of the flexible extension portion 514 can befolded over at point 520 (FIG. 33.3) to run adjacent to the rigidportion 516, as shown in FIG. 33.3. In the example shown, the proximalleg 514 a of the flexible board extension is at an angle ofapproximately 90 degrees with respect to the rigid board extension. Insome embodiments, the angle may be less than or more than 90 degrees,due to the flexibility of the flexible board extension permitting theproximal leg 514 a to accommodate an imperfectly aligned fold. Theflexible PCB extension 514 is shown running adjacent to the rigid PCBextension 516 in FIG. 33.4 along the endoscope shaft (inner sheath,sensor housing and lens removed for clarity). In this manner, both PCBextensions can pass through an elastomeric slot in a bulkhead or fluidbarrier, such as the slot 177 shown in FIG. 11B or 11C.

FIG. 33.5 shows a cutaway view of an exemplary endoscope. The main PCB518 is shown in relation to the handle proximal section 16, the cameracontrol button 37 the bulkhead or pass-through barrier 159, and pivotcontrol structure 100. Rotational position sensor magnets 51 are shownboth in relation to the handle proximal section 16 and the main PCB 518.An exemplary fluid conduit 434 (for irrigation or suction) is shownapproaching the bulkhead 159. It may be connected to bulkhead 159through a barb fitting 256 as shown in FIG. 33.6, or through any othersuitable means of secure connection. In this case, the inner sheath 312has been removed for clarity of the description.

FIG. 33.6 shows the PCB of the endoscope without the handle, innersheath, pivot control structure and fluid conduit, as its extensionspass through the bulkhead or pass-through barrier 159. In addition, therotation position sensing magnets 51 and the camera control button 37and shaft 38 (with embedded magnet) are shown in relation to the mainPCB 518 to provide an indication of where on the PCB 518 the respectiveHall effect sensors for those magnets can be located. As shown, the foldpoint 520 of the flexible PCB extension is located proximal to thebulkhead 159, so that the combined adjacent flexible and rigid PCBextensions may pass through the bulkhead at slot 177. The slot in thiscase can be sealed securely against fluid infiltration, because asufficient amount of slack in the flexible PCB extension 514 can beprovided distally near its termination at the sensor 512.

As shown in FIG. 33.7, a fluid or air carrying lumen 157 shares spacewithin the endoscope shaft 14 with the PCB extensions 514, 516 (oralternatively with one or two ribbon or flex cables), which supply powerto the light source and communications with the sensor/camera located atthe distal end of the endoscope shaft 14. The sensor/camera housing hasbeen removed for clarity. (Note that the inner sheath 312 of the shaft14 has a cutout or opening proximal to the sensor/camera housing, aboveto provide illumination by the light source or LED's, and optionallybelow to improve fluid flow around the sensor/camera housing. This isshown, for example in FIGS. 23.1 and 72.6).

FIG. 33.8 shows a cutaway view of the interior of the handle distalsection 30 of the above endoscope. The bulkhead or fluid barrier 159separates a relatively dry region (in which the pivot control structure,camera control button, and distal end of the main PCB are located) froma wet section 30 a. A fluid or air conduit 434 runs from the outside ofthe endoscope handle, through the handle proximal section 16, andconnects to a port 256 of the bulkhead 159. In this example, fluidpassing through the conduit 434 and port 256 communicates with the lumen157 of the endoscope shaft 14 via the space occupied by the wet section30 a. Appropriate seals can be used to contain this fluid so that fluidor air does not leak out between the distal section housing and theproximal end of the endoscope inner sheath 312.

Referring now back to FIGS. 7C and 14, the pivot control structure 100may be capable of being “parked” in detents defined by ridges 94 in theslide button recess 92 of the handle raised portion 34 or anotherportion of the handle 12. In some embodiments, the ridges 94 may bespaced such that the detents formed by the ridges 94 may correspond withspecific angular orientations of the camera assembly 350. In someembodiments, the detents formed by the ridges 94 may be spaced such thattheir location corresponds to specific angular increments (e.g. 30°) ofthe camera assembly 350.

As mentioned above (see FIG. 7A), the handle distal section 30 may berotatable relative to the handle proximal section 16. Such rotationwould also cause the longitudinal axis of the insertion section 14 torotate as well. In turn, the camera assembly 350 may rotate with theinsertion section 14. This may allow a user to get a near-global view ofthe anatomical area in question with minimal to no angular repositioningof the endoscope 10. A user may need only to pan the camera assembly 350and rotate the handle distal section 30 relative to the handle proximalsection 16 to obtain a desired field of view within an anatomical area.

Repeated contortion and bending of optical fibers such as the opticalfibers 364 may lead to fracturing or failure of one or more fibers. Inthe instance of the optical fibers 364, this leads to light andillumination loss which increases as more optical fibers 364 becomecompromised. Such bending may occur if the optical fibers 364 terminateand are attached or fused to a portion of a pivoting camera assembly 350as described above. If the endoscope 10 is designed to be disposable,then any decrement in the integrity or performance of the optical fibers364 may be within acceptable limits relative to the intended lifespan ofthe instrument. Consequently, in some embodiments the optical fibers 364may be attached or fused to a pivotal camera assembly 350 with minimalconcern for optical fiber 364 breakage and resultant light loss. Aterminal illuminator, light projection element or light emitterassociated with the optical fibers 364 may, in some embodiments, beadvantageously mounted to the camera assembly 350 in order to projectlight at whatever target or field of view a lens assembly 354 of thecamera assembly 350 has been rotated or panned to. Such an arrangementhelps to ensure that the field of view (shown with dashed lines in FIG.23-25) for the lens assembly 354 is always illuminated by the opticalfibers 364 regardless of where the in the camera assembly's 350 pannablerange the camera assembly 350 has been rotated to.

In some embodiments, the illumination system may include a light guideor light pipe 375. In some embodiments, the optical fibers 364 maycomprise a light guide or light pipe 375 (see, for example, FIG. 35)along at least a part of the path of the illumination system. The terms“light guide” and “light pipe” are herein used interchangeably. When anoptical fiber is relatively straight, light loss is relatively smallbecause the angle of incidence of the light within the fiber is shallowenough to facilitate near total reflection within the optical fiber.Bending the optical fiber, however, may alter the angle of incidence tothe point where some transmission of light out of the fiber is possible.Bends of a light pipe or guide may, however, be controlled. For thisreason, use of a light guide 375 where feasible may help to minimizelight loss in an illumination system comprising optical fibers 364 ormay replace the optical fibers altogether. A light guide 375 may alsoprovide a number of other benefits. For example, a light guide 375 mayaid in assembly and shorten assembly time for a device. The light guide375 may be of the types described herein or may be any suitable typelight guide known to those skilled in the art.

FIG. 35 shows an example embodiment of an endoscope 10 utilizing lightpipes 375. Two larger diameter light pipes 375 may extend along one ormore sections of the wall of the inner sheath 312 (see FIG. 18) to thecamera assembly housing 330 and then bend or curve into one of thecamera assembly pivot bearings 346. The bent section of each light pipe375 may be coated with a highly reflective material 376 in order tominimize loss of light out of the light pipe 375 as it changesdirection. Any suitable highly reflective material 376 known to oneskilled in the art may be used. In such embodiments, the camera assembly350 may also have built-in camera assembly light pipes 377 that areformed in a junction with the light pipes 375 at the pivot bearings 346.The light carried by the light pipes 375 may be transferred to thecamera assembly light pipes 377 at the junction. The camera assemblylight pipes 377 may extend from each of the pivot pins 366 into thecamera assembly 350. The camera assembly light pipes 377 terminate inthe light projection voids 362 so that the field of view of the cameraassembly 350 will be illuminated regardless of the rotational positionof the camera and lens assemblies. In such an embodiment, any bendstaken by the camera assembly light pipes 377 may be coated with a highlyreflective material 376 as described above. In some embodiments, thehighly reflective material 376 may be included on other portions of thelight pipes 375 and camera assembly light pipes 377 in addition to thebends of the light pipes 375 and camera assembly light pipes 377.

Creating a light pipe junction coinciding with the pivoting region ofthe camera assembly 350 may be desirable because it avoids the bendingor twisting of optical fibers 364 as the camera assembly 350 is rotated,removing the risk of damage to the optical fibers 364. Such a design canbe adapted for use in either a reusable or disposable endoscope 10. Thisarrangement may also reduce the manufacturing or assembly costs of theendoscope 10.

In another example embodiment (not shown) which uses light pipes 375, alarger diameter light pipe 375 may extend substantially along the pathof the flex cable 250. The end of the light pipe 375 nearest the innersheath mount 160 may form a junction with the optical fibers 364 or bearranged to draw in light from another illumination source. The end ofthe light pipe 375 nearest the camera assembly 350 may also form ajunction with illumination fibers 364 which extend to the cameraassembly 350.

In some embodiments, the optical fibers 364 to the camera assembly 350may be arranged to form a flexible ribbon 1000, creating a linear arrayof fibers that can be terminated into a light projection element withminimal bending or bending in only one dimension (see, e.g., FIG. 36).Alternatively, the flexible ribbon 1000 need not be a linear array offibers and instead may, in some embodiments, be a single, ribbon-like,flexible piece of light guide material. In some embodiments there may betwo flexible ribbons 1000 each extending to one of the light projectionvoids 362 in the camera assembly 350. In some embodiments, the flexibleribbons 1000 may be coated with a reflective material 376 to maximizethe amount of light at the camera assembly 350. In some embodiments, aflexible ribbon 1000 may form a junction with a light pipe.

In some embodiments, a camera housing top 356 may comprise a lightpiping material to serve as a light projection element or illuminator.In this case, light may be emitted from most of the camera housing top356 and into the viewing field of the camera assembly 350. In someembodiments, some areas of the camera housing top 356 may be blacked outor masked so that light is only emitted from a desired region or regionsof the camera housing top 356. In some embodiments, some regions of thecamera housing top 356 may be coated with a highly reflective material376 to prevent the unwanted emission of light from those areas.

FIG. 36 shows an embodiment in which the optical fibers 364 areincorporated into a flexible ribbon 1000, which optionally may be coatedin a highly reflective material 376. As shown, the flexible ribbon 1000extends to the camera assembly 350. The flexible ribbon 1000 may beover-molded to, potted into, fused with or otherwise coupled to thecamera assembly 350.

In the example embodiment in FIG. 36 the camera assembly 350 comprises amonolithic camera housing 1002. An example monolithic camera housing1002 without an attached flexible ribbon 1000 is shown in greater detailin FIG. 37. In the example embodiment, the monolithic camera housing1002 is made from a light piping or transmitting material and functionsas a light projection element. The monolithic camera housing 1002 in theexample embodiment may be nearly entirely coated with a highlyreflective material 376 to maximize light output from the non-coated ornon-masked regions of the monolithic camera housing 1002. A lightprojection or illumination surface 1004 having a shape suitable forplacement adjacent a lens and image sensor assembly on the monolithiccamera housing 1002 may be constructed by masking the area duringapplication of a highly reflective material 376 (or alternatively asimple dark mask). In the example embodiment, the light projectionsurface 1004 has the shape of a ring. In other embodiments, the lightprojection surface 1004 may be crescent-shaped, semi-circular, or mayhave any other desired shape. Light may be emitted from the lightprojection surface 1004 of the monolithic camera housing 1002 toilluminate the field of view of the lens assembly 354. As in theabove-described embodiments, the field of illumination preferably pivotswith the camera assembly 350, ensuring that the field of view of thelens assembly 354 is always illuminated.

FIG. 38 shows another example embodiment of a monolithic camera housing1002. As shown in outline form, the monolithic camera housing 1002includes a coupling recess 1006. The coupling recess 1006 may allow aflexible ribbon 1000 to be suitably coupled into the monolithic camerahousing 1002. In some embodiments, the coupling recess 1006 may allow aflexible ribbon 1000 to be coupled, for example, via snap fit into themonolithic camera assembly 1002. In some embodiments, the couplingrecess 1006 may accommodate optical fibers 364 not formed in a flexibleribbon 1000. Similar to FIG. 37, in FIG. 38, the monolithic camerahousing 1002 may function as a light projecting element. The monolithiccamera housing 1002 may also be similarly coated and/or masked as themonolithic camera housing 1002 described in relation to FIG. 37.

FIG. 39 and FIG. 40 show an embodiment in which a light projectionelement 1005 is incorporated in an end of a flexible ribbon 1000. Thelight projection element 1005 may be formed from a light pipingmaterial, which in some embodiments may be a fusion of a group of fibersinto a shape suitable for projecting light from a fiberoptic bundle orflexible ribbon 1000 in a desired manner. In some embodiments, the lightprojection element 1005 and flexible ribbon 1000 may be two separateparts fused together (e.g., by heating or by chemical means). In otherembodiments the light projection element 1005 and flexible fiberopticribbon 1000 may be a single molded part. In some embodiments the lightprojection element 1005 may be created as described in relation to FIGS.49-62.

Still referring to FIGS. 39 and 40, the flexible ribbon 1000 may becoated with a highly reflective material 376. The bottom and side wallsof the light projection element 1005 may also be coated with a highlyreflective material 376. This may ensure that light is only emitted fromthe non-coated top of the light projection element 1005 and into thefield of view of the lens assembly 354. As show in FIG. 40, the lightprojection element 1005 or the flexible ribbon 1000 may include acoupling feature 1008. The coupling feature 1008 may allow the lightprojection element 1005 and flexible ribbon 1000 to be coupled onto orinto a camera assembly 350. The coupling feature 1008 may be an integralpart of the light projection element 1005.

FIG. 41 and FIG. 42 depict two example embodiments of a flexible ribbon1000 which include light projection elements 1005, which may be formedfrom a light piping material. The light projection element 1005 in FIG.41 has a generally ring-like shape while the light projection element1005 in FIG. 42 is generally crescent shaped, although other shapes maybe selected as desired. In the example embodiments in FIGS. 41 and 42only the top surfaces of the light projection elements 1005 are leftuncoated with a highly reflective material 376.

A light projection element 1005 may comprise one or a number of textures1010 that help to direct the light emitted from the light projectionelements 1005. In some embodiments, the texture 1010 or textures 1010may be included to encourage light to be emitted in a diffuse manner.The texture 1010 or textures 1010 may be created, for example, duringmolding of the light projection element 1005, or alternatively, thelight piping material forming the light projection element 1005 mayinclude a fill material that encourages light to be emitted from thelight projection element 1005 in a diffuse manner.

FIGS. 43 and 44 respectively depict top and bottom perspective views ofanother example embodiment of a light projection element 1005. As shown,the light projection element 1005 is ring-like in shape. The lightprojection element 1005 also includes a coupling feature 1008 as shownin bottom perspective view in FIG. 44. The coupling feature 1008 in FIG.44 is an integral part of the light projection element 1005. In theexample embodiment, the coupling feature 1008 is a ledge or shelf. Theledge coupling feature 1008 may help to locate and/or align the lightprojection element 1005 on another component such as a camera assembly350. Additionally, in some embodiments, adhesive or glue may be placedalong the ledge coupling feature 1008 to fix the light projectionelement 1005 to another component such as a camera assembly 350. Thelight projection element 1005 is shown attached to an example cameraassembly 350 in FIG. 48.

The light projection element 1005 shown in FIGS. 43-44 does not includea highly reflective coating or material 376 (see, for example. FIG. 39).The need for such a highly reflective coating or material 376 may beminimized by dimensioning the light projection element 1005 to increaseor maximize the total internal reflection of light entering and withinthe light projection element 1005 where the emission of light is notdesired. This may be done by ensuring any bend or bends have a largeradius in areas of the light projection element 1005 where the emissionof light is undesired. Additionally, this may be done by dimensioning alight projection element 1005 such that thickness variations throughoutthe light projection element 1005 do not introduce changes in the angleof incidence of light within the light projection element 1005 whichwould make the angle of incidence less than the critical angle. It maybe desirable that the thickness of the light projection element 1005does not decrease to less than the thickness of the optical fibers orflexible ribbon to which the light projection element is attached 1005.It may also be desirable that the surface of the light projectionelement 1005 be smooth in areas where the emission of light is notdesired.

FIGS. 45, 46, and 47 depict a number of cross sections of the lightprojection element 1005 depicted in FIGS. 43-44. The cross sections arerespectively taken at lines 43-43, 44-44, and 45-45 of FIG. 43. Asshown, light entering the light projection element 1005 must traverse afirst bend 1300 and second bend 1302 before being emitted out of the topsurface of the light projection element 1005. As shown in FIGS. 45-47,the light projection element 1005 may be shaped such that the radii ofthese bends vary depending on the plane of the light projection element1005. The radius of each of these bends 1300 and 1302 may be chosen soas to be as gradual as possible in the available space in a given plane.Also as shown, the thickness of the light projection element 1005 iskept generally constant. This ensures that changes in angle incidencedue to thickness variation are minimized.

The light projection element 1005 shown and described in relation toFIGS. 43-47 is attached to an example camera assembly 350 in FIG. 48. Asshown the light projection element 1005 is arranged such that itprojects light into a primary illumination field (the surrounding areaaround this primary illumination field also may be illuminated due todiffusion and reflection of the emitted light) which is substantiallycoincident with the field of view of the lens assembly 354.

Exemplary methods for constructing a fiberoptic light projecting elementare disclosed in U.S. patent application Ser. No. 14/170,080 (USApplication Publication No. 2014/0221749), filed Jan. 31, 2014, andincorporated herein by reference in its entirety.

FIG. 63 shows a cross sectional view of an exemplary camera assemblyincluding a lens assembly 354 taken at the cross-sectional planerepresented by line 61-61 of FIG. 24. The lens assembly 354 is shownhoused between the camera housing top 356 and camera housing bottom 358as in FIG. 24. As shown, the lens assembly 354 is positioned to projectan image onto the plane of an image sensor 380. The type of image sensor380 may include, for example, a CCD image sensor, CMOS image sensor,etc. Preferably, the image sensor 380 may be housed in a sealed sectionof the camera assembly 350 to guard against fluid exposure. In adisposable endoscope, a less costly process may be used to seal theimage sensor against fluid exposure (e.g., using a clear epoxycompound), because the assembly would not then be designed to withstandthe rigors of sterilization and reuse.

As shown in FIG. 63 the image sensor 380 may be electrically coupled toa flex board 381 of the flex cable 250. In some embodiments, a conformalcoating material may be used to give added protection against moisture,and optionally may be constructed to support the joints of a ball gridarray mounting for the image sensor 380. The flex cable 250 may providepower to the image sensor 380, as well as the means of conveyance ofdata and/or commands from/to the image sensor 380. In some embodiments,a stiffener 382 may be included in the camera assembly 350. In theexample embodiment shown in FIG. 63, a stiffener 382 is positioned tostrengthen the structure on which the image sensor 380 is supported,which may help to protect the physical integrity of the image sensor380. The stiffener 382 may comprise, for example, a thin aluminumbacking (which in an exemplary embodiment may be about 0.002 inchthick).

The camera assembly 350 may also include one or a number of fiber guides384. In the example shown in FIG. 63, a fiber guide 384 is coupled tothe bottom face of the camera housing bottom 358. The example fiberguide 384 includes a guide trough 386. The back wall of the guide trough386 of the fiber guide 384 may be seen projecting toward the bottom ofthe page in FIG. 63. The fiber guide 384 may also be or include a numberof directing notches or channels 388 which in the example fiber guide384 shown in FIG. 63 are recessed into the back wall of the guide trough386. In some embodiments, including the exemplary embodiment in FIG. 63,directing notches or channels 388 may be formed in one or both of thecamera housing top 356 and camera housing bottom 358. The fiber guide384 may help to route the illumination fibers 364 during assembly of theendoscope 10. The fiber guide 384 may also act to keep the illuminationfibers 364 in place during operation of the endoscope 10. The location,shape, number, size, etc. of the fiber guides 384 may vary depending onthe specific configuration of the endoscope 10. In some embodiments,glue, epoxy or another suitable adhesive or agent may be used inaddition to the fiber guides 384 to help keep the illumination fibers364 in the desired location. In some cases, for example, in which lightguides or light projection element (as shown, e.g., in FIG. 35-42 or asshown in FIG. 64) are used, fiber guides 384 may not be used in anassembly.

FIG. 64 depicts a cross section of the camera assembly 350 depicted inFIG. 34 taken at line 62-62 of FIG. 34. As shown, a lens assembly 354 isshown in place in the camera housing 355. An image sensor 380 is alsoshown in place within the camera housing 355. The lens assembly ispositioned to project an image to the image sensor 380. As above, theimage sensor 380 may be any type of image sensor (e.g. CCD, CMOS, etc.)and may be sealed against fluid exposure. Also as above, the imagesensor 380 is coupled onto a flex board 381 attached to a flex cable250. The camera assembly 350 shown in FIG. 64 does not include a fiberguide 384 (see FIG. 63). Instead a light projection element or lightemitter 2005 is in place on the camera assembly 350 in FIG. 64.

As shown, the flex cable 250 is doubled back upon itself in the exampleembodiment. This may be accomplished by bending the flex cable 250 andthen maintaining the bend by applying glue or another fixative to theaffected areas of the flex cable 250. Double-looping the flex cable 250below the camera assembly 350 may be advantageous in embodiments inwhich the camera assembly 350 is enclosed in a confined space. Forexample, confining the camera assembly 350 to the space within an innersheath 312 as shown in FIG. 22 may limit the amount of flex cable 250available for bending. The flex cable 250 may then have to bend over anundesirably small radius in certain rotation positions of the cameraassembly 350. Such a small bend radius can be detrimental to a flexcable 250 especially if it occurs repeatedly. This problem becomes moreof an issue as the diameter of the inner sheath 312 decreases. Byarranging the flex cable 250 to double back upon itself, however, agreater length of flex cable 250 is available for repeated bending uponrotation of the camera assembly 350 and a larger minimum bend radius maybe obtained. Thus, this may allow the inner sheath 312 to then be madewith a smaller diameter without concern for the integrity of the flexcable 250 due to the repeated bending and unbending over a small radius.

Both the flex cable 250 and the optical fibers 364 leading the lightprojection element 2005 exhibit some resistance to bending.Additionally, both can exert a restoring spring force when bent. Thisresistance to bending may increase the camera assembly's 350 resistanceto rotation. As shown in FIG. 65, the flex cable 250 and the opticalfibers 364 may be angled toward one another. Such an arrangement mayleverage the stiffness of the flex cable 250 against the optical fibers364 or vice versa to assist in rotating camera assembly 350. To bestillustrate this concept, the flex cable 250 is not doubled back uponitself in FIG. 65.

In some embodiments, at least one illumination source for a cameraassembly 350 may be positioned to project light in a direction otherthan into the field of view of the camera assembly 350. That is, thedirect illumination field of an illumination source may be oriented suchthat it is outside or not coincident with a field of view of a cameraassembly. Such an illumination source may be referred to as an indirectlighting source whereas illumination sources which project lightdirectly into a field of view of a camera assembly 350 may be referredto as direct lighting sources. An indirect lighting source may, forexample, be oriented such that it emits light behind a camera assembly350 or in a direction substantially opposite that of the field of viewof the camera assembly 350. For example, instead or in addition to alight projecting element 2005 which couples around a lens assembly 354or lens and projects light into a field of view of the lens assembly 354or lens, a light projecting element 2005 may be attached to part of thecamera assembly 350 opposite the lens assembly 354 or lens.

Though counter-intuitive, projecting light outside of the field of viewof the camera assembly 350 (e.g. behind a camera assembly 350 in adirection opposite the field of view) provides increased image qualityand reduces the need for image processing. For example, such anillumination arrangement may help to provide greater depth perception inendoscopic procedures as shadowing of areas which would otherwise bedirectly illuminated may be maintained. By emitting light from a lightprojecting element 2005 or other illumination source to points outsidethe field of view of a camera assembly 350, hot spots or areas whichappear washed out and dark spots or areas which appear underexposed maybe mitigated. Such an illumination arrangement may help to provide moreuniform lighting within the field of view of the camera assembly 350.

A representational embodiment of an illumination arrangement in whichlight may be emitted from a number of light sources 702 a-d to areasinside and outside of a field of view 700 of a camera assembly 350 isshown in FIG. 66. As shown, an extension 430 h of a printed circuitboard in the endoscope handle is shown extending to the camera assembly350. The printed circuit board extension 430 h may provide power anddata communication pathways to various components in the insertionsection 14. In some embodiments, a ribbon or flex cable 250 (see, e.g.,FIG. 14) may be used instead of a printed circuit board extension 430 h.A number of components are mounted to the printed circuit boardextension 430 h. These components may be any or a variety of differentcomponents such as a sensors, light emitters, etc. In the exampleembodiment, the components are described as light sources 702 a-d. Thelight sources 702 a-d may be any suitable light source, such as but notlimited to, fiber optic cables, light projecting elements 2005 (see,e.g. FIG. 62), LEDs, or arrays of LEDs.

Use of LEDs may be desirable in some specific embodiments for a varietyof reasons. For example, use of LEDs may obviate the need for abundle/ribbon of illumination fibers, some specific embodiments. Someoptical fibers may degrade when subjected to prolonged bending duringusage and may be prone to light loss when bent. LEDs are long lastingand do not require a lengthy bundle of fibers which a subject tobending. Use of LEDs may also minimize the number of pass-throughelements between a dry section (e.g. a handle 12) of an endoscope and awet section of an endoscope (e.g. insertion section 14). Additionally,by omitting optical fibers less of the cross-sectional area of a fluidconduit in an insertion section 14 may be obstructed or filled. This mayallow for increased flow rates of irrigation fluid through an insertionsection 14. LEDs may also help to simplify or increase ease ofmanufacturing.

As shown, a first light source 702 a is disposed such that it mayproject light generally toward the field of view 700 of the cameraassembly 350. Such a light source 702 a may generally provide directlighting of the field of view 700. In some embodiments, a direct lightsource 702 a may be omitted or may be accompanied by one or more otherindirect lighting sources, such as, for example, any or a combination oflight sources 702 b-d. In embodiments where a direct lighting source 702a is included in conjunction with one or more indirect lighting source,the direct lighting source 702 a may provide light at a lower intensitythan one or more of the indirect lighting sources. In some embodiments,a direct lighting source 702 a may provide light in a different spectrumor a subset of the spectrums emitted by an indirect lighting source(s).For example, a direct lighting source 702 a may be a RBG LED array whileindirect lighting sources may emit white light.

A number of other lighting sources 702 b-d are also shown in FIG. 66.These lighting sources are shown together for illustrative purposes, andneed not all be present in any given embodiment. Any number of lightingsources 702 a-d may be included in various embodiments. Some of thelighting sources 702 a-d may be omitted in various embodiments. Each ofthe light sources 702 b-d is an indirect lighting source is arrangedsuch that they do not emit light directly into the field of view 700 ofthe camera assembly 350. Light sources 702 b-d are arranged to emitlight in a direction substantially opposite the field of view 700 of thecamera assembly 350. Light source 702 d may be attached to the cameraassembly 350 and may be arranged to emit light from a side of the cameraassembly 350. In a preferred embodiment, backlighting provides the onlysource of illumination of the surgical field. In this case, anillumination source for the distal end of the endoscope may onlycomprise one or more LED's located at position 702B, for example; thatis, projecting light from a side of the endoscope shaft that is awayfrom the side from which most of the field of view of the cameraassembly is directed. The light thus provided illuminates the spaceviewed by the camera assembly more indirectly and diffusely, preventingbright reflections of light aimed directly at the camera or reducing thecasting of shadows, and improving the operator's view of the field. Onthe other hand, placing the LED's at position 702A may improveillumination of the area of the surgical field toward which the camerafield of view 700 is directed.

The camera assembly 350 may include one or more optical filters toselectively use the wavelengths emitted from one or more of the lightsources 702 a-d. For example, a polarizing filter or band-gap filter maybe used to enhance the imaging by the camera assembly 350.

Depending on the embodiment, the camera assembly 350 may be rotatablewithin the insertion section 14. In such embodiments, the lightingsources 702 a-d may remain stationary as the camera assembly 350 isrotated. Alternatively, one or more lighting source 702 a-d may rotatewith the camera assembly 350 (e.g. a light source 702 a-d may beattached to the camera assembly 350 and thus rotate with the cameraassembly 350). A light source 702 a-d may be positioned such that itdoes not emit light directly into the field of view 700 in any or alarge percentage (e.g. from around 70% to 100%) of the possiblerotational positions of the camera assembly 350. In some embodiments,the entire distal end of the shaft or insertion section 14 (or theentire insertion section 14) may be transparent such that the cameraassembly 350 may be rotated therein to obtain many viewing anglesthrough the transparent portion or portions; In this specificembodiment, the distal portion of the insertion section 14 optionallymay be fluidly sealed from the surrounding space, the camera and lightsource relying on the transparency of the distal end of the shaft.

Additionally, in some embodiments, a controller monitoring therotational position of the camera assembly 350 may increase or decreasethe intensity of light emitted by various light sources 702 a-ddepending on the position of the field of view 700. For example, acontroller may monitor displacement of a pivot control structure 100(see, e.g. FIG. 14) via a sensor such as a rotational potentiometerattached to a pivot shaft 204 (see, e.g. FIG. 14). Based on datacollected from the sensor, a controller may determine if a light source702 a-d has shifted from a direct light source to an indirect lightsource or vice versa. The controller may then adjust the intensity oflight produced by that light source 702 a-d accordingly. Based on thesensor reading, the controller may, for example, determine which lightsources 702 a-d are emitting light into the field of view 700 of thecamera assembly 350 and decrease the intensity of light produced bythose light sources 702 a-d. A controller may use the sensor reading todetermine if the camera assembly 350 has been rotated such that a lightsource 702 a-d which was previously emitting light directly into thefield of view 700 is now acting as an indirect light source. Upondetermination that a light source 702 a-d has shifted from a directlight source to an indirect light source the intensity of light producedby that light source 702 a-d may be increased. The adjustment of theemitted light may be done in a continuous, gradual fashion, step wisefashion, or binary manner (e.g. switching between a preset direct andindirect intensity level).

An example of a printed circuit board 430 a which includes a number ofLED light sources 750 and a sensor 754 on an extension 430 h of theprinted circuit board 430 a is shown in FIGS. 67-68. A sensor or cameraassembly 350 is also shown at the end of the PCB extension 430 h. FIG.67 depicts a top down view of the printed circuit board 430 a, whileFIG. 68 depicts a side view of the printed circuit board 430 a.

The printed circuit board 430 a may include a main portion 430L fromwhich a shaft portion 430H extends. The main portion 430 l of theprinted circuit board 430 a may be housed in the handle 12 (see, e.g.FIG. 3A or 3B) of an endoscope 10. In the example embodiment shown inFIGS. 67-68, the main portion 430 l is not shown populated withelectronic components for sake of simplicity. An example printed circuitboard 430 a populated with exemplary components 430 b-f is depicted inFIG. 96. In some embodiments, and as shown in FIG. 68, at least aportion of the main portion 430L of the printed circuit board 430 a maybe coated or encased in a protective coating or layer of material. Theprotective material may be any of a variety of potting material orconformal coating materials. Acrylic, epoxy, polyurethane, silicones,parylene, thermo-setting plastics, rubber, or any other potting materialor conformal coating material may be used. Preferably, the protectivematerial is biocompatible and provides waterproofing characteristics. Atransparent protective coating may also be placed over the LEDs 750 andsensor 754 on the projecting portion 430 h.

The PCB extension (or optionally ribbon cable) 430 h may extend througha pass-through barrier 159 (see, e.g. FIG. 15) and along the axis of aninsertion section 14 (see, e.g. FIG. 15) of an endoscope 10. Theprojecting portion 430 h may provide power and data communicationpathways to various components (e.g. a camera assembly 350 and/or LEDs750) within the insertion section 14 (see, e.g., FIG. 15). Theprojecting portion 430 h may be divided into a number of differentparts. In the example shown, the projecting portion 430 h includes afirst portion 430 i, second portion 430 j, and a third portion 430 k.(In other embodiments, the projecting portion 430 h may be divided intoa different number of components). Each part of the projecting portion430 h may possess different characteristics. For example, each part ofthe projecting portion 430 h may have differing levels of flexibility.Certain parts may be rigid circuit board, while other parts are flexcable. Additionally, each part of the circuit board may have differentnumber of layers, different widths, different numbers of traces on eachlayer, etc. It may be desirable that at least one part of the projectingportion 430 h of the printed circuit board 430 a be a flex cable or beotherwise flexible. This may help to facilitate rotation of the cameraassembly 350.

In some embodiments, the first portion 430 i may be a six layer rigidcircuit board. The second portion 430 j may be a 2 layer flex cable. Thethird portion 430 k may be a 4 layer rigid circuit board. Each sectionmay transition into the next section or connectors may be used betweenone or more section of the projecting portion 430 h. To simplifymanufacturing and to reduce costs, it may be preferable that thecommunications and power lines in the endoscope shaft comprise flexibleand/or rigid extensions of the main PCB located in the endoscope handle.The entire PCB with extension(s) can be manufactured as shown in FIG.33.2, and any flexible PCB extension can be folded over as shown in FIG.33.3 to run adjacent to a companion PCB extension (rigid or flexible)during assembly of the endoscope.

The sensor 754 may be any of a variety of sensors. In some embodiments,the sensor 754 may be a temperature sensor such as a thermistor,thermocouple, or resistance temperature detector. In some specificembodiments, the sensor 754 may be thermistor. A temperature sensor 754may be used to monitor the temperature of the environment near or at theLEDs 750.

During an endoscopic procedure, irrigation fluid may flow over the LEDs750. This fluid may help to cool the LEDs 750 keeping the temperature ofthe LEDs 750 within a desired temperature range. In the event that anendoscope 10 is outside of a patient and irrigation fluid is notrunning, a controller may monitor data from the sensor 754 to determineif the environment near the LEDs 750 is becoming hotter than a desiredtemperature range. In the event that temperature exceeds the temperaturerange, the controller may command current flow to the LEDs 750 to belowered or the controller may command the LEDs 750 off. A temperaturesensor may also be used as an irrigation fluid flow sensor. During anendoscopic procedure, the flow rate of irrigation fluid may besufficient to dissipate heat produced by the LEDs 750 via convectionsuch that the area surrounding the LEDs 750 is within a desiredtemperature range. In the event that the flow rate decreases beyond acertain amount, the temperature in the area proximal to the LEDs 750 mayrise. This rise may, in some embodiments, be interpreted by a controlleras a decrease in irrigation fluid flow rate. In response, the controllermay generate a notification to user to this effect.

FIG. 69 depicts a flowchart detailing a number of example steps whichmay be used by a controller to control LEDs in an insertion section 14based on a sensed temperature. In step 756, a controller receives a datasample from a temperature sensor near the LEDs. The controller thenanalyzes the data sample in step 758. If 760 the temperature is notoutside of a first predefined range, step 756 may be repeated. If 760the temperature is outside of the first predefined range, the controllermay transition one or more LED from a first state to a second state instep 762. The temperature range may have a high bound of between 40-50degrees Celsius (e.g. 50 degrees Celsius). The first state may be a highlight output intensity on-state and the second state may be anoff-state. In the example flowchart, the second state is a dimmed oroff-state. The controller receives a data sample from the temperaturesensor in step 764 and analyzes the data sample in step 766. If 768 thedata sample indicates the temperature is outside of a secondpredetermined range, step 764 may be repeated. If 768 the data sampleindicates that the temperature is within the second predefined range, atleast one LED may be turned on or commanded to increase the intensity oflight it produces in step 770.

The first and second predefined ranges may be the same, or the first andsecond predefined ranges may differ, with the second predefined rangebeing less than the first predefined range. This may ensure that thecontroller does not rapidly cycle between turn on/off or dimming andincreasing the intensity of light from the LEDs. In some embodiments,after reaching step 762, a timer may be started. The timer may be aminimum dim or off time timer for the at least one LED whose brightnesshas been modified. In the event that the minimum off or dim timer hasnot elapsed, the at least one LED may not be turned back or commanded toincrease light output intensity even if the temperature is within thesecond predefined range. This may again help to prevent rapid cyclingbetween LED states.

FIG. 70 depicts a close-up side view of an example of the end of theprojecting portion 430 h of the printed circuit board 430 a. As shown,the projecting portion 430 h includes a first portion 430 i, secondportion 430 j, and third portion 430 k. A camera assembly 350 isattached to the third portion 430 k. A sensor 754 is mounted on thefirst portion 430 i in the vicinity of a number of LEDs 750 a-d. Thesensor 754 may be a temperature sensor such as a thermistor and may beused to aid in control of the LEDs 750 a-d. Sensors for detectingcharacteristics of a fluid environment other than temperature (e.g.,conductivity, pH, etc.) may also be used.

LED 750 a may be a direct lighting source and generally projects lightinto the field of view 700 of the camera assembly 350. LED 750 a ismounted to a first side 430 m of the first portion 430 i of theprojecting portion 430 h. LEDs 750 b-d are mounted on a second side 430n of the first portion 430 i which is opposite the first side 430 m.These LEDs 750 b-d may be indirect light sources and in some embodimentsmay not project light directly into the field of view 700 of the cameraassembly 350 in any rotational orientation of the camera assembly 350.In some embodiments, LED 750 a may be a RBG LED array. LED 750 a may beadjusted to provide light at a spectrum which may help to modify thecolor of the image produced by an image sensor of the camera assembly350 in a desired manner. For example, LED 750 a may be adjusted tocorrect a color bias of an image sensor of the camera assembly 750 a.LEDs 750 b-d may be white light LEDs. As shown, the first portion 430 iof the projecting portion 430 h may be a thicker portion of printedcircuit board relative to other portions 430 j, 430 k of the projectingportion 430 h. This may allow the power demands of the LEDs 750 a-d tobe easily accommodated.

The first portion 430 i may transition into the second portion 430 j ofthe projecting portion 430 h. The second portion 430 j may be arelatively thin flex cable. The second portion 430 j may facilitaterotation of the camera assembly 350 about the axis of the pivot pins 366of the camera assembly 350. As shown, the second portion 430 j may be ofa length such that when the first portion 430 i and third portion 430 kare parallel to one another, the second portion 430 j is bowed orarched. This may help to allow for increased range of motion of thecamera assembly 350.

FIG. 71 depicts an example embodiment of a camera assembly housing 330of an insertion section 14. FIG. 72 depicts a cross-sectional view ofthe camera assembly housing 330 taken at line 72-72 of FIG. 71. Thecamera assembly housing 330 is continuous with the inner sheath 312 andboth can be formed as a single part. As shown in FIG. 71-72 a projectingportion 430 h of a printed circuit board 430 a (see, e.g., FIG. 68) isshown within the camera assembly housing 330. The projecting portion 430h is similar to that shown in FIG. 70 and includes a camera assembly350, a number of LEDs 750 a-d and, optionally, a sensor 754. As shown,the LEDs 750 a-d are arranged such that they may emit light out of thetop and bottom openings 338, 340 of the camera assembly housing 330. Thecamera assembly 350 may be panned such that its field of view can beswept from the embrasured opening 344 at the rounded tip 342 through theopening provided by the top void 338. When fully assembled an outersheath 318 (see, e.g. FIG. 22) may be placed over the camera assemblyhousing 330 and inner sheath 312 to protect the camera assembly 350while still providing an unobstructed field of view.

FIG. 23.1 shows a perspective view of the distal end of the shaft of anendoscope (or arthroscope) 14 in which the sensor or camera housing 500is positioned at the tip of the shaft. In this case the inner sheath 312has no distal-most protective guard, shield or tip structure. At least aportion of the rotatable sensor or camera housing 500 (i.e. thedistal-most portion) forms the distal-most element of the endoscopeinsertion end. Thus the sensor housing 500 is preferably constructed towithstand repeated contact with anatomical structures including softtissue, bone, cartilage or articular surfaces. In an embodiment, asdescribed above for camera housing 350, the rounded or dome-shapedcamera housing 500 may also include a light source, movable with therotatable camera housing, and continuously directed toward the field ofview of the camera housing 500. The light source may comprise, forexample, one or more LED's, or the terminus of a fiberoptic bundle. Inthe example shown in FIG. 23.1, a light source 508 (in this case a bankof LED's) is positioned on a side of the shaft just proximal to thelocation of the rotatable sensor or camera housing 500. In theillustration, the light source 508 is on the side that directsillumination toward the general field of view of the camera/lensassembly 500 when rotated to approximately 90 degrees with respect tothe long axis of the endoscope shaft 14. (Alternatively, the lightsource may be arranged to be opposite the side on which the cameraassembly—lens and sensor—can be oriented). In the arrangement shown, theoptical axis of the camera assembly can be directed generally toward thedirection of light projected from a first side of the insertion end ofthe endoscope. In other arrangements, the light source is positioned ona second opposing side of the insertion end, projecting light away fromthe second side of the insertion end of the endoscope, while the opticalaxis of the camera assembly can be directed generally toward a field ofview opposite the first side of the insertion end of the endoscope. FIG.72.1 shows a perspective view of this latter arrangement, in which thelight emitted by the light source 508 (LED's in this example) isdirected to a region generally away from the field of view of the sensorand lens 512. The alternative second arrangement is intended to provideindirect illumination (or backlighting) of the field of view of thecamera assembly, relying on the ambient light generated by theillumination source in the operative field of the endoscope. Theillumination source or LED's are mounted to be flush with or recessedfrom the outer surface of the inner sheath or shaft of the insertionend. If recessed, there is less likelihood that heat generated by theLED's will directly touch or injure nearby tissues in the operativefield.

Referring now to FIG. 73, in embodiments which include at least onevariable illumination source which may produce light at differentintensities and/or spectrums, the endoscope 10 may be placed in acalibration fixture 780 to aid in setting various lighting parameters.An embodiment with one or more white LED and one or more colored LED(e.g. a RBG LED array) may for example be placed in a calibrationfixture prior to usage to adjust light output intensity of its LEDs andadjust the color output of the one or more colored LED. This may help toensure more uniform image quality and minimize differences betweenendoscopes 10 which may be attributable to variation between their LEDsand/or image sensors.

The calibration fixture 780 may be a light-tight box or other volumeincluding an opening 782 sized to fit the insertion section 14 of theendoscope 10. This opening 782 may be gasketed such that a light-tightseal is formed against the insertion section 14 of the endoscope 10 whenthe endoscope 10 is installed in the calibration fixture 780. Theinterior of the calibration fixture 780 may include one or moretarget(s) with known characteristics placed within the field of view ofa camera assembly 350 (see, e.g. FIG. 71) of the endoscope 10. Forexample targets with known color characteristics may be placed withinthe calibration fixture 780.

A controller may monitor characteristics of the one or more target(s) inthe image captured by an image sensor of a camera assembly 350. Sincethe characteristics (e.g. color) of the targets is known, the controllermay adjust the lighting provided by the variable light source(s) untilthe characteristics of the target(s) in the captured image match or arewithin a range of the target's or targets' known characteristics. Forexample, the intensity of light and/or spectrum of light produced by anumber of LEDs 750 a-d (see, e.g. FIG. 70) included in the insertionsection 14 may be adjusted.

FIG. 74 depicts a flowchart detailing a number of example steps whichmay be used to calibrate one or more lighting parameter of at least onevariable light source included in an endoscope. In step 784 a portion ofthe insertion section of an endoscope including a camera assembly may beplaced in a calibration fixture. Once inserted, a controller may commandvariable illumination sources in the endoscope to emit light in step786. The light may be emitted based on default parameters (e.g. lightintensity and color parameters). In step 788, a controller may receiveimage date from an image sensor of an endoscope's camera assembly. Thisdata may be analyzed by a controller in step 790. The image data may,for example, be analyzed to determine one or more characteristics ofinterest of a target or targets in the captured image. Thesecharacteristics may be compared, in step 792, to the known or expectedcharacteristics of the target or targets which have been imaged. If 794the characteristics of the target in the captured image are within arange of the known or expected characteristics, the calibration may beconsidered complete in step 796. If 794 the characteristics of thetarget or targets in the captured image are not within a range of theknown or expected characteristics, a controller may adjust one or moreillumination parameter of at least one variable illumination source ofthe endoscope in step 798. In the example embodiment, the intensityand/or spectrum of light produced by at least one variable light sourceis adjusted in step 798. Step 788 may repeated after adjustment. Imagesmay continue to be compared and analyzed and illumination parameters maybe adjusted until the characteristics of targets in the captured imageare within range of their known or expected values.

Various methods may be used in the construction and assembly of a lensor group of lenses to focus images onto the sensor or camera at thedistal end of the endoscope shaft. Examples of such methods andtechniques are disclosed in U.S. patent application Ser. No. 14/170,080(US Application Publication No. 2014/0221749), filed Jan. 31, 2014, andincorporated herein by reference in its entirety.

FIG. 96 shows another example embodiment of the endoscope 10. An outersheath 318 is shown installed on the endoscope in FIG. 96. Additionally,only the bottom half-shell 22 of the handle proximal section 16, andhalf (30 a) of the handle distal section 30 are visible for clarity ofthis description. As shown, the endoscope 10 includes a handle-enclosedprinted circuit board 430 a (also referred to herein as handle or mainPCB 430 a). An electronic cable (such as, e.g., a power/HDMI cable) 432,optical fibers 364, and irrigation/suction line 434 are also shown. FIG.96 shows example routing pathways for the power/HDMI cable 432, opticalfibers 364, and irrigation line 434. As shown, the electronic cable 432,optical fibers 364, and irrigation line 434 enter the endoscope 10through an opening 60 at the rear or butt end of the handle proximalsection 16. This entry point may be more advantageous than a handleside-entry point because it reduces the potential of various cords andcables to get tangled as the insertion section is rotated relative tothe handle proximal section 16.

In some embodiments, the electronic cable 432, optical fibers 364 (ifpresent), and irrigation line 434 may enter the endoscope 10 at an anglewith respect to the rear handle opening 60. Such an arrangement wouldafford an ergonomic benefit to the user by allowing the user to grasp agreater portion of the rear portion of the handle proximal section 16.

As shown, the electronic cable 432, optical fibers 364 (if implementedin the endoscope), and irrigation line 434 extend over a portion of thehandle PCB 430 a after entering the handle proximal section 16. Theelectronic cable 432 plugs into a connector 430 b (such as, e.g. apower/HDMI connector) on the handle PCB 430 a. The electronic cable 432may provide power to the endoscope 10. Image data may pass to the handlePCB 430 a via the flex cable 250. The electronic cable 432 may transmitvisual data collected by the endoscope 10 to an external graphical userinterface display (not shown). The optical fibers 364 (if implemented inthe endoscope) and irrigation line 434 extend under the handle PCB 430 aand follow the pathways previously described. In embodiments in whichthe endoscope 10 is disposable, the electronic cable 432, optical fibers364, and irrigation line 434 may all be included as disposablecomponents to ensure sterility each time an endoscope is used, or tosave on the costs of sterilization and packaging for re-use.

In this example, a control wire 91 for button 90 is also shown in FIG.96. As shown, the control wire 91 passes through an orifice in thesealing member 210. The control wire 91 is in communication with thehandle PCB 430 a. Also as shown in FIG. 96 the handle PCB 430 a includesa handle PCB flex cable 430 e. The handle PCB flex cable 430 e connectsto a handle PCB portion 430 f, permitting PCB portion 430 f to beoriented at an angle (e.g., perpendicular) to the rest of the handle PCB430 a. When assembled, the flex attached handle PCB portion 430 f may bedisposed between the two potentiometers 122 of the example rotationsensing assembly 150 (see FIG. 8).

In some embodiments, the handle PCB 430 a may include an image orgraphic processing unit 430 c. Preferably, however, the image processingunit 430 c is located external to the endoscope 10. The image processingunit 430 b may function as an electronic righting mechanism for theendoscope 10. The image processing unit 430 c may receive the imagecaptured by the image sensor 380 which is sent from the image sensor 380to the handle PCB 430 a via the flex cable 250. In a preferredembodiment, the image captured by the image sensor 380 is thentransmitted to the image processing unit 430 c external to the endoscope10 via the electronic cable 432. The image processing unit 430 c mayalso receive a signal from the rotation sensing assembly 150. In someembodiments, an analog to digital converter 430 d may be included on thehandle PCB 430 a to convert the signal from the rotation sensingassembly 150. The image processing unit 430 c may use the signal fromthe rotation sensing assembly 150 to electronically “right” the image toa desired orientation. In some embodiments, image may be rotated by theimage processing unit 430 c so that the image is displayed as if it werecaptured from the user's point of view. In some embodiments, the imageprocessing unit 430 c may also correct for the effects of lensdistortion.

Unless the orientation of an image displayed on a graphical userinterface is first corrected, the displayed image may be disorienting tothe user. By defining a direction according to the user's point of view,the image processing unit 430 c may use data from the rotation sensingassembly 150 to automatically rotate images so that images correspondwith the user's point of view.

FIG. 97 shows an example block diagram of an imaging system. As shown,the imaging system includes an image sensor 380 that captures an image.The image captured by the image sensor 380 may be passed via a cameraserial interface 450 (for example a MIPI camera serial interface) to animage processing unit 452. The image processing unit 452 (IPU) may thenmove image frames to other hardware components in the imaging system.Other hardware components may include, but are not limited to, a memorydevice and a graphical processing unit 430 c (GPU). The graphicalprocessing unit 430 c may correct any distortion caused by the lensassembly 354.

In some embodiments, the graphical processing unit 430 c may correctthis distortion by representing the image as a texture on a surface thathas been loaded into the graphical processing unit 430 c. This may causethe image to be adjusted or stretched in a manner which corrects and/orremoves the distortion introduced by the lens assembly 354. Inembodiments where the image is righted, the graphical processing unit430 c may then rotate the corrected image via input from a rotationsensing assembly 150 (see, for example, FIG. 8). For example, themeasurement from a rotation sensing assembly 150 may be passed to thegraphical processing unit 430 c through an analog to digital converter430 d (see, for example, FIG. 96). The signal from the analog to digitalconverter 430 d may then be used to rotate the image to its rightedorientation. In some embodiments, a user may be able to toggle imagerighting, distortion correction, and/or various other imagemanipulations which may be performed on or off. Image righting will befurther described later in the specification in relation to FIG. 98.

The processed image from the image processing unit 430 c may then bedisplayed on a graphical user interface or display 454. In someembodiments, the processed image from the image processing unit 430 cmay be stored in memory. In such embodiments, a user may capture imagesto be stored in memory for later recall by triggering a button 90, forexample. Some embodiments may include a video processing unit 456 whichmay encode the frames from the image sensor 380 into a recordable videoformat. In such embodiments, encoded video may then be stored in memory.A user may command the endoscope to initiate and stop video capture viainteraction with a button such as button 90 as described above.

In some embodiments, the image processing unit 430 c may also subject acaptured image to exposure feedback analysis. In specific embodiments,an image histogram may be created from all the pixels of the image. Theimage histogram may then be used to tune the image or tune the exposureof subsequent images received by the image chip or sensor 380. Suchfurther processing by the image processing unit 430 c may help to reduceblown-out white areas of the image or underexposed dark areas of theimage. Other means of tuning an image or images, such as, for example,tone mapping, etc. may also be used.

FIG. 98 depicts an example diagram illustrating how an image may berighted using input from a rotation sensing assembly 150 (see, forexample, FIG. 98). As shown, a first block 2100 and a second block 2102are depicted. Within each block 2100, 2102 is an endoscope 10 having afield of view 2104 is depicted. The field of view 2104 of the endoscope10 in the first block 2100 is oriented approximately 180 degrees fromthe endoscope 10 in the second block 2102. This may be accomplished byrotating the distal end of the endoscope 10 relative to the proximal endof the endoscope 10. In conventional endoscopes 10, during rotation ofthe distal section relative to the proximal section, the image sensordoes not rotate because the image sensor is housed in the proximalsection. Thus, the endoscopes 10 shown in the first block 2100 andsecond block would both capture image 2106.

This would not be the case In some embodiments described herein in whichthe image sensor 380 rotates with the distal end of the endoscope 2106.The endoscope 10 shown in the first block 2100 would capture image 2106,while the same endoscope 10 rotated to the position shown in the secondblock 2102 would capture image 2108. As the image sensor rotates withthe distal end of the endoscope 10, the image sensor will invert theimage. In this position, for example, the top of the image sensor willpick up what one accustomed to a conventional endoscope 10 would expectto be the bottom of the image.

Optionally, the image may be rotated in proportion to the degree ofrotation of the distal end of the endoscope 10. Thus the image canalways be displayed in a way which would be expected by a useraccustomed to conventional endoscopes 10. This may help to alleviateproblems associated with a rotating image sensor.

Various embodiments shown in the drawings are presented only todemonstrate certain examples of features of the disclosure. Not allfeatures shown in any given drawing necessarily have to be included in aclaimed device or feature. The drawings are to be interpreted only forillustrative purposes; as such, the size of some of the elements may beexaggerated and not drawn to a particular scale. Additionally, elementsshown within the drawings that have the same reference numbers may beidentical elements or may represent similar or analogous elements,depending on the context.

Any terms such as “first”, “second”, “third” and the like, whether usedin the description or in the claims, are intended to distinguish betweensimilar elements and not necessarily to describe a sequential orchronological order. It is to be understood that the terms so used areinterchangeable under appropriate circumstances (unless clearly statedotherwise) and that the embodiments of the disclosure described hereinare capable of operation in other sequences and/or arrangements than aredescribed or illustrated herein.

The invention claimed is:
 1. A printed circuit board for use in anendoscope comprising: a base portion configured to reside within ahandle of the endoscope; and one or more elongate extension portionsconfigured to extend from the base portion in the handle through a shaftof the endoscope and terminating at a distal insertion end of the shaft;the base portion comprising a composite of a flexible board and a rigidboard, the flexible board comprising a first one of the one or moreextension portions, and the rigid board comprising a second one of theone or more extension portions of the printed circuit board; wherein theflexible board extension portion and the rigid board extension portionemerge from the base portion adjacent to each other, wherein a proximalleg of the flexible board extension portion extends away from the rigidboard extension portion at an angle of approximately 90 degrees from therigid board; and wherein the one or more elongate extension portions andthe base portion are formed from a single composite structure.
 2. Theprinted circuit board of claim 1, wherein the proximal leg of theflexible board extension portion is folded to permit the distal leg ofthe flexible board extension portion to be aligned parallel to andadjacent to the rigid board extension portion through the shaft of theendoscope.
 3. The printed circuit board of claim 2, wherein the rigidboard extension portion and the flexible board extension portion extendthrough a lumen of the endoscope shaft.
 4. The printed circuit board ofclaim 3, wherein the base portion of the printed circuit board, therigid board extension portion, and the flexible board extension portionare coated with a water resistant coating or membrane.
 5. The printedcircuit board of claim 4, wherein the rigid board extension portion andthe flexible board extension portion extend through a fluid-carryinglumen of the endoscope shaft.
 6. The printed circuit board of claim 1,wherein the rigid board extension portion carries electrical linesconnected to one or more light sources at the insertion end of theendoscope shaft.
 7. The printed circuit board of claim 1, wherein theflexible board extension portion carries communication lines connectedto an image sensor at the insertion end of the endoscope shaft.
 8. Theprinted circuit board of claim 7, wherein the image sensor comprises aCCD or CMOS sensor.
 9. The printed circuit board of claim 8, wherein theflexible board extension portion is configured to permit the imagesensor to rotate about an axis generally perpendicular to a long axis ofthe endoscope shaft.
 10. A printed circuit board for use in an endoscopecomprising: a base portion configured to reside within a handle of theendoscope; and one or more elongate extension portions configured toextend from the base portion in the handle through a shaft of theendoscope and terminating at a distal insertion end of the shaft; thebase portion comprising a composite of a flexible board and a rigidboard, the flexible board comprising a first one of the one or moreextension portions; the rigid board comprising a second one of the oneor more extension portions of the printed circuit board; wherein therigid board extension portion carries electrical lines connected to oneor more light sources at the insertion end of the endoscope shaft; andwherein the one or more elongate extension portions and the base portionare formed from a single composite structure.
 11. The printed circuitboard of claim 10, wherein the flexible board extension portion and therigid board extension portion emerge from the base portion adjacent toeach other, wherein a proximal leg of the flexible board extensionportion extends away from the rigid board extension portion at an angleof approximately 90 degrees from the rigid board extension portion, andwherein a distal leg of the flexible board extension portion extendsaway from the base portion parallel to the rigid board extensionportion.
 12. The printed circuit board of claim 11, wherein the proximalleg of the flexible board extension portion is folded to permit thedistal leg of the flexible board extension portion to be alignedparallel to and adjacent to the rigid board extension portion throughthe shaft of the endoscope.
 13. The printed circuit board of claim 12,wherein the rigid board extension portion and the flexible boardextension portion extend through a lumen of the endoscope shaft.
 14. Theprinted circuit board of claim 13, wherein the base portion of theprinted circuit board, the rigid board extension portion, and theflexible board extension portion are coated with a water resistantcoating or membrane.
 15. The printed circuit board of claim 14, whereinthe rigid board extension portion and the flexible board extensionportion extend through a fluid-carrying lumen of the endoscope shaft.16. The printed circuit board of claim 10, wherein the flexible boardextension portion carries communication lines connected to an imagesensor at the insertion end of the endoscope shaft.
 17. The printedcircuit board of claim 16, wherein the image sensor comprises a CCD orCMOS sensor.
 18. The printed circuit board of claim 17, wherein theflexible board extension portion is configured to permit the imagesensor to rotate about an axis generally perpendicular to a long axis ofthe endoscope shaft.
 19. A printed circuit board for use in an endoscopecomprising: a base portion configured to reside within a handle of theendoscope; and one or more elongate extension portions configured toextend from the base portion in the handle through a shaft of theendoscope and terminating at a distal insertion end of the shaft; thebase portion comprising a composite of a flexible board and a rigidboard, the flexible board comprising a first one of the one or moreextension portions, and the rigid board comprising a second one of theone or more extension portions of the printed circuit board; wherein theflexible board extension portion and the rigid board extension portionemerge from the base portion adjacent to each other, and wherein aproximal leg of the flexible board extension portion extends away fromthe rigid board extension portion at an angle of approximately 90degrees from the rigid board.
 20. The printed circuit board of claim 19,wherein the proximal leg of the flexible board extension portion isfolded to permit the distal leg of the flexible board extension portionto be aligned parallel to and adjacent to the rigid board extensionportion through the shaft of the endoscope.
 21. The printed circuitboard of claim 20, wherein the rigid board extension portion and theflexible board extension portion extend through a lumen of the endoscopeshaft.
 22. The printed circuit board of claim 21, wherein the baseportion of the printed circuit board, the rigid board extension portion,and the flexible board extension portion are coated with a waterresistant coating or membrane.
 23. The printed circuit board of claim22, wherein the rigid board extension portion and the flexible boardextension portion extend through a fluid-carrying lumen of the endoscopeshaft.
 24. The printed circuit board of claim 19, wherein the rigidboard extension portion carries electrical lines connected to one ormore light sources at the insertion end of the endoscope shaft.
 25. Theprinted circuit board of claim 19, wherein the flexible board extensionportion carries communication lines connected to an image sensor at theinsertion end of the endoscope shaft.
 26. The printed circuit board ofclaim 25, wherein the image sensor comprises a CCD or CMOS sensor. 27.The printed circuit board of claim 26, wherein the flexible boardextension portion is configured to permit the image sensor to rotateabout an axis generally perpendicular to a long axis of the endoscopeshaft.
 28. A printed circuit board for use in an endoscope comprising: abase portion configured to reside within a handle of the endoscope; andone or more elongate extension portions configured to extend from thebase portion in the handle through a shaft of the endoscope andterminating at a distal insertion end of the shaft; wherein the baseportion comprises a composite of a flexible board and a rigid board, theflexible board comprises a first one of the one or more extensionportions, and the rigid board comprises a second one of the one or moreextension portions of the printed circuit board; and wherein the rigidboard extension portion carries electrical lines connected to one ormore light sources at the insertion end of the endoscope shaft.
 29. Theprinted circuit board of claim 28, wherein the flexible board extensionportion and the rigid board extension portion emerge from the baseportion adjacent to each other, wherein a proximal leg of the flexibleboard extension portion extends away from the rigid board extensionportion at an angle of approximately 90 degrees from the rigid boardextension portion, and wherein a distal leg of the flexible boardextension portion extends away from the base portion parallel to therigid board extension portion.
 30. The printed circuit board of claim29, wherein the proximal leg of the flexible board extension portion isfolded to permit the distal leg of the flexible board extension portionto be aligned parallel to and adjacent to the rigid board extensionportion through the shaft of the endoscope.
 31. The printed circuitboard of claim 30, wherein the rigid board extension portion and theflexible board extension portion extend through a lumen of the endoscopeshaft.
 32. The printed circuit board of claim 31, wherein the baseportion of the printed circuit board, the rigid board extension portion,and the flexible board extension portion are coated with a waterresistant coating or membrane.
 33. The printed circuit board of claim32, wherein the rigid board extension portion and the flexible boardextension portion extend through a fluid-carrying lumen of the endoscopeshaft.
 34. The printed circuit board of claim 28, wherein the flexibleboard extension portion carries communication lines connected to animage sensor at the insertion end of the endoscope shaft.
 35. Theprinted circuit board of claim 34, wherein the image sensor comprises aCCD or CMOS sensor.
 36. The printed circuit board of claim 35, whereinthe flexible board extension portion is configured to permit the imagesensor to rotate about an axis generally perpendicular to a long axis ofthe endoscope shaft.